A&U - April 2014 by A&U: America's AIDS Magazine

APRIL 2014 • ISSUE 234 • AMERICA’S AIDS MAGAZINE

DESERT AIDS PROJECT CREATES AN OASIS IN PALM SPRINGS

ARTIST DUDLEY SAUNDERS THINKS INSIDE THE BOX

TED ALLEN DINES OUT FOR LIFE A FUNCTIONAL CURE FOR HIV EDITS ITS PROFILE

david

BURTKA THE ACTOR & CHEF SUSTAINS HIS PASSION TO PROTECT THE HEALTH & HAPPINESS OF OUR COMMUNITIES

What is STRIBILD? STRIBILD is a prescription medicine used to treat HIV-1 in adults who have never taken HIV-1 medicines before. It combines 4 medicines into 1 pill to be taken once a day with food. STRIBILD is a complete singletablet regimen and should not be used with other HIV-1 medicines. STRIBILD does not cure HIV-1 infection or AIDS. To control HIV-1 infection and decrease HIV-related illnesses you must keep taking STRIBILD. Ask your healthcare provider if you have questions about how to reduce the risk of passing HIV-1 to others. Always practice safer sex and use condoms to lower the chance of sexual contact with body fluids. Never reuse or share needles or other items that have body fluids on them.

IMPORTANT SAFETY INFORMATION What is the most important information I should know about STRIBILD?

• Worsening of hepatitis B (HBV) infection. If you also have HBV and stop taking STRIBILD, your hepatitis may suddenly get worse. Do not stop taking STRIBILD without first talking to your healthcare provider, as they will need to monitor your health. STRIBILD is not approved for the treatment of HBV.

• Take a medicine that contains: alfuzosin, dihydroergotamine, ergotamine, methylergonovine, cisapride, lovastatin, simvastatin, pimozide, sildenafil when used for lung problems (Revatio®), triazolam, oral midazolam, rifampin or the herb St. John’s wort. • For a list of brand names for these medicines, please see the Brief Summary on the following pages.

• If you take hormone-based birth control (pills, patches, rings, shots, etc).

• Take any other medicines to treat HIV-1 infection, or the medicine adefovir (Hepsera®).

• If you take antacids. Take antacids at least 2 hours before or after you take STRIBILD.

What are the other possible side effects of STRIBILD?

• If you are pregnant or plan to become pregnant. It is not known if STRIBILD can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking STRIBILD.

Do not take STRIBILD if you:

Serious side effects of STRIBILD may also include:

• Build-up of an acid in your blood (lactic acidosis), which is a serious medical emergency. Symptoms of lactic acidosis include feeling very weak or tired, unusual (not normal) muscle pain, trouble breathing, stomach pain with nausea or vomiting, feeling cold especially in your arms and legs, feeling dizzy or lightheaded, and/or a fast or irregular heartbeat.

• New or worse kidney problems, including kidney failure. Your healthcare provider should do regular blood and urine tests to check your kidneys before and during treatment with STRIBILD. If you develop kidney problems, your healthcare provider may tell you to stop taking STRIBILD.

• You may be more likely to get lactic acidosis or serious liver problems if you are female, very overweight (obese), or have been taking STRIBILD for a long time. In some cases, these serious conditions have led to death. Call your healthcare provider right away if you have any symptoms of these conditions.

• All your health problems. Be sure to tell your healthcare provider if you have or had any kidney, bone, or liver problems, including hepatitis virus infection. • All the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. STRIBILD may affect the way other medicines work, and other medicines may affect how STRIBILD works. Keep a list of all your medicines and show it to your healthcare provider and pharmacist. Do not start any new medicines while taking STRIBILD without first talking with your healthcare provider.

Who should not take STRIBILD?

STRIBILD can cause serious side effects:

• Serious liver problems. The liver may become large (hepatomegaly) and fatty (steatosis). Symptoms of liver problems include your skin or the white part of your eyes turns yellow (jaundice), dark “tea-colored” urine, light-colored bowel movements (stools), loss of appetite for several days or longer, nausea, and/or stomach pain.

What should I tell my healthcare provider before taking STRIBILD?

• Bone problems, including bone pain or bones getting soft or thin, which may lead to fractures. Your healthcare provider may do tests to check your bones. • Changes in body fat can happen in people taking HIV-1 medicines. • Changes in your immune system. Your immune system may get stronger and begin to fight infections. Tell your healthcare provider if you have any new symptoms after you start taking STRIBILD. The most common side effects of STRIBILD include nausea and diarrhea. Tell your healthcare provider if you have any side effects that bother you or don’t go away.

• If you are breastfeeding (nursing) or plan to breastfeed. Do not breastfeed. HIV-1 can be passed to the baby in breast milk. Also, some medicines in STRIBILD can pass into breast milk, and it is not known if this can harm the baby.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. Please see Brief Summary of full Prescribing Information with important warnings on the following pages.

STRIBILD is a prescription medicine used as a complete single-tablet regimen to treat HIV-1 in adults who have never taken HIV-1 medicines before. STRIBILD does not cure HIV-1 or AIDS.

I started my personal revolution Talk to your healthcare provider about starting treatment. STRIBILD is a complete HIV-1 treatment in 1 pill, once a day. Ask if itâ&#x20AC;&#x2122;s right for you.

Patient Information STRIBILD® (STRY-bild) (elvitegravir 150 mg/cobicistat 150 mg/emtricitabine 200 mg/ tenofovir disoproxil fumarate 300 mg) tablets Brief summary of full Prescribing Information. For more information, please see the full Prescribing Information, including Patient Information.

• Do not stop taking STRIBILD without first talking to your healthcare provider • If you stop taking STRIBILD, your healthcare provider will need to check your health often and do blood tests regularly for several months to check your HBV infection. Tell your healthcare provider about any new or unusual symptoms you may have after you stop taking STRIBILD

What is STRIBILD?

Who should not take STRIBILD?

• STRIBILD is a prescription medicine used to treat HIV-1 in adults who have never taken HIV-1 medicines before. STRIBILD is a complete regimen and should not be used with other HIV-1 medicines. • STRIBILD does not cure HIV-1 or AIDS. You must stay on continuous HIV-1 therapy to control HIV-1 infection and decrease HIV-related illnesses. • Ask your healthcare provider about how to prevent passing HIV-1 to others. Do not share or reuse needles, injection equipment, or personal items that can have blood or body fluids on them. Do not have sex without protection. Always practice safer sex by using a latex or polyurethane condom to lower the chance of sexual contact with semen, vaginal secretions, or blood.

Do not take STRIBILD if you also take a medicine that contains: • adefovir (Hepsera®) • alfuzosin hydrochloride (Uroxatral®) • cisapride (Propulsid®, Propulsid Quicksolv®) • ergot-containing medicines, including: dihydroergotamine mesylate (D.H.E. 45®, Migranal®), ergotamine tartrate (Cafergot®, Migergot®, Ergostat®, Medihaler Ergotamine®, Wigraine®, Wigrettes®), and methylergonovine maleate (Ergotrate®, Methergine®) • lovastatin (Advicor®, Altoprev®, Mevacor®) • oral midazolam • pimozide (Orap®) • rifampin (Rifadin®, Rifamate®, Rifater®, Rimactane®) • sildenafil (Revatio®), when used for treating lung problems • simvastatin (Simcor®, Vytorin®, Zocor®) • triazolam (Halcion®) • the herb St. John’s wort Do not take STRIBILD if you also take any other HIV-1 medicines, including: • Other medicines that contain tenofovir (Atripla®, Complera®, Viread®, Truvada®) • Other medicines that contain emtricitabine, lamivudine, or ritonavir (Atripla®, Combivir®, Complera®, Emtriva®, Epivir® or Epivir-HBV®, Epzicom®, Kaletra®, Norvir®, Trizivir®, Truvada®) STRIBILD is not for use in people who are less than 18 years old.

What is the most important information I should know about STRIBILD? STRIBILD can cause serious side effects, including: 1. Build-up of lactic acid in your blood (lactic acidosis). Lactic acidosis can happen in some people who take STRIBILD or similar (nucleoside analogs) medicines. Lactic acidosis is a serious medical emergency that can lead to death. Lactic acidosis can be hard to identify early, because the symptoms could seem like symptoms of other health problems. Call your healthcare provider right away if you get any of the following symptoms which could be signs of lactic acidosis: • feel very weak or tired • have unusual (not normal) muscle pain • have trouble breathing • have stomach pain with nausea or vomiting • feel cold, especially in your arms and legs • feel dizzy or lightheaded • have a fast or irregular heartbeat 2. Severe liver problems. Severe liver problems can happen in people who take STRIBILD. In some cases, these liver problems can lead to death. Your liver may become large (hepatomegaly) and you may develop fat in your liver (steatosis). Call your healthcare provider right away if you get any of the following symptoms of liver problems: • your skin or the white part of your eyes turns yellow (jaundice) • dark “tea-colored” urine • light-colored bowel movements (stools) • loss of appetite for several days or longer • nausea • stomach pain You may be more likely to get lactic acidosis or severe liver problems if you are female, very overweight (obese), or have been taking STRIBILD for a long time. 3. Worsening of Hepatitis B infection. If you have hepatitis B virus (HBV) infection and take STRIBILD, your HBV may get worse (flare-up) if you stop taking STRIBILD. A “flare-up” is when your HBV infection suddenly returns in a worse way than before. • Do not run out of STRIBILD. Refill your prescription or talk to your healthcare provider before your STRIBILD is all gone

What are the possible side effects of STRIBILD? STRIBILD may cause the following serious side effects: • See “What is the most important information I should know about STRIBILD?” • New or worse kidney problems, including kidney failure. Your healthcare provider should do blood and urine tests to check your kidneys before you start and while you are taking STRIBILD. Your healthcare provider may tell you to stop taking STRIBILD if you develop new or worse kidney problems. • Bone problems can happen in some people who take STRIBILD. Bone problems include bone pain, softening or thinning (which may lead to fractures). Your healthcare provider may need to do tests to check your bones. • Changes in body fat can happen in people who take HIV-1 medicine. These changes may include increased amount of fat in the upper back and neck (“buffalo hump”), breast, and around the middle of your body (trunk). Loss of fat from the legs, arms and face may also happen. The exact cause and long-term health effects of these conditions are not known. • Changes in your immune system (Immune Reconstitution Syndrome) can happen when you start taking HIV-1 medicines. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Tell your healthcare provider right away if you start having any new symptoms after starting your HIV-1 medicine.

The most common side effects of STRIBILD include: • Nausea • Diarrhea Tell your healthcare provider if you have any side effect that bothers you or that does not go away. • These are not all the possible side effects of STRIBILD. For more information, ask your healthcare provider. • Call your healthcare provider for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. What should I tell my healthcare provider before taking STRIBILD? Tell your healthcare provider about all your medical conditions, including: • If you have or had any kidney, bone, or liver problems, including hepatitis B infection • If you are pregnant or plan to become pregnant. It is not known if STRIBILD can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking STRIBILD. - There is a pregnancy registry for women who take antiviral medicines during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. Talk with your healthcare provider about how you can take part in this registry. • If you are breastfeeding (nursing) or plan to breastfeed. Do not breastfeed if you take STRIBILD. - You should not breastfeed if you have HIV-1 because of the risk of passing HIV-1 to your baby. - Two of the medicines in STRIBILD can pass to your baby in your breast milk. It is not known if the other medicines in STRIBILD can pass into your breast milk. - Talk with your healthcare provider about the best way to feed your baby. Tell your healthcare provider about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements: • STRIBILD may affect the way other medicines work, and other medicines may affect how STRIBILD works. • Be sure to tell your healthcare provider if you take any of the following medicines: - Hormone-based birth control (pills, patches, rings, shots, etc) - Antacid medicines that contain aluminum, magnesium hydroxide, or calcium carbonate. Take antacids at least 2 hours before or after you take STRIBILD - Medicines to treat depression, organ transplant rejection, or high blood pressure - amiodarone (Cordarone®, Pacerone®) - atorvastatin (Lipitor®, Caduet®) - bepridil hydrochloride (Vascor®, Bepadin®) - bosentan (Tracleer®) - buspirone - carbamazepine (Carbatrol®, Epitol®, Equetro®, Tegretol®) - clarithromycin (Biaxin®, Prevpac®) - clonazepam (Klonopin®) - clorazepate (Gen-xene®, Tranxene®) - colchicine (Colcrys®) - medicines that contain dexamethasone - diazepam (Valium®)

- digoxin (Lanoxin®) - disopyramide (Norpace®) - estazolam - ethosuximide (Zarontin®) - flecainide (Tambocor®) - flurazepam - fluticasone (Flovent®, Flonase®, Flovent® Diskus®, Flovent® HFA, Veramyst®) - itraconazole (Sporanox®) - ketoconazole (Nizoral®) - lidocaine (Xylocaine®) - mexiletine - oxcarbazepine (Trileptal®) - perphenazine - phenobarbital (Luminal®) - phenytoin (Dilantin®, Phenytek®) - propafenone (Rythmol®) - quinidine (Neudexta®) - rifabutin (Mycobutin®) - rifapentine (Priftin®) - risperidone (Risperdal®, Risperdal Consta®) - salmeterol (Serevent®) or salmeterol when taken in combination with fluticasone (Advair Diskus®, Advair HFA®) - sildenafil (Viagra®), tadalafil (Cialis®) or vardenafil (Levitra®, Staxyn®), for the treatment of erectile dysfunction (ED). If you get dizzy or faint (low blood pressure), have vision changes or have an erection that last longer than 4 hours, call your healthcare provider or get medical help right away. - tadalafil (Adcirca®), for the treatment of pulmonary arterial hypertension - telithromycin (Ketek®) - thioridazine - voriconazole (Vfend®) - warfarin (Coumadin®, Jantoven®) - zolpidem (Ambien®, Edlular®, Intermezzo®, Zolpimist®) Know the medicines you take. Keep a list of all your medicines and show it to your healthcare provider and pharmacist when you get a new medicine. Do not start any new medicines while you are taking STRIBILD without first talking with your healthcare provider. Keep STRIBILD and all medicines out of reach of children. This Brief Summary summarizes the most important information about STRIBILD. If you would like more information, talk with your healthcare provider. You can also ask your healthcare provider or pharmacist for information about STRIBILD that is written for health professionals, or call 1-800-445-3235 or go to www.STRIBILD.com. Issued: October 2013

COMPLERA, EMTRIVA, GILEAD, the GILEAD Logo, GSI, HEPSERA, STRIBILD, the STRIBILD Logo, TRUVADA, and VIREAD are trademarks of Gilead Sciences, Inc., or its related companies. ATRIPLA is a trademark of Bristol-Myers Squibb & Gilead Sciences, LLC. All other marks referenced herein are the property of their respective owners. © 2014 Gilead Sciences, Inc. All rights reserved. STBC0076 03/14

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c o n t e n t s April 2014

40 Cover Actor & Chef David Burtka Talks with A&U’s Dann Dulin About Increasing Our Vigilance When Practicing Prevention, Staying Upbeat & Strengthening Our Communities to Work Toward the End of AIDS

Departments

Features 32 Gallery Dudley Saunders Turns Keepsakes into a Form of Public Memory 34 Full Plate Ted Allen Dines Out for Life to Make Sure AIDS Funding Is Not Chopped 36 Crazy Like a Fox Spokes Person: Actress Traci Dinwiddie Cycles for Life 38 Rolling Heart into a Hard Role Actor Tim Cummings Finds the Right Beats of The Normal Heart 46 Resident Good Desert AIDS Project Provides a Deep Well of Compassion & Services for Individuals Living with HIV/AIDS 16 Poetry by Michelle Perez 27 Poetry by Michael Hurley cover by Annie Tritt

Frontdesk

Mailbox

NewsBreak

Ruby’s Rap

Tim Courtney

viewfinder 24

Just*in Time

First Generation

lifeguide 50

Treatment Horizons

Destination: Cure

Hep Talk

The Culture of AIDS

Lifelines

Survival Guide

A&U Frontdesk

Lost in Emotion

irplanes disappear without a trace. Epidemics continue without an end in sight. What phenomenon makes the first a riveting mystery that demands closure and the second something that can be slowed to a crawl? What mystifies me is how much media attention has been paid to the loss of Malaysia Airlines Flight 370 off the southwestern coast of Australia. When the 2005 Tsunami killed nearly half a million people, the news dwelled on this natural catastrophe and extreme loss of human life. I thought the news coverage was commensurate with the level of tragedy. The news cycle finally moved on. When the earthquake in Haiti happened it stayed in the spotlight for some time but then faded as the storyline grew static, though actor Sean Penn was frequently able to bring attention back to the suffering of an entire nation, including thousands living with HIV who couldn’t access their HIV meds due to the severe interruption of basic health services. So why is the crash of a Malaysian airliner such a fixation of the evening news (even to the point that we forget that Russia is amassing troops on Ukraine’s eastern border)? Is it because it is a mystery; and mysteries make for good ratings? As with Amelia Earhart’s disappearance way back when, which, by the way, still makes headlines, people are mesmerized by the trail of clues and the promise of an a-ha moment—when a wreckage is discovered, or hijackers reveal they landed a plane on a secret airfield, or the pilot is found to have had a suicidal plan. AIDS isn’t a mystery: We know what happened; we know what is happening; and we know what will happen. We know how the virus is transmitted. We know it continues to take over a million lives every year. We know we need to improve access to healthcare. We know lives could be extended. A “rescue” is there for the taking. So, how can we get the news channels to cover HIV/AIDS with as much diligence as they’ve covered Flight 370, with experts at the ready to talk about every aspect of the epidemic and hi-tech graphics to show the prevalence of HIV from region to region? If we must, we could repackage HIV/

A M E R I C A’ S A I D S M A G A Z I N E issue 234 vol. 23 no. 4 April 2014 editorial offices: (518) 426-9010 fax: (518) 436-5354

AIDS as a mystery. We certainly don’t know everything there is to know about the virus itself. It even acts mysteriously, hiding out in reservoirs. We don’t know how exactly to create a functional cure. We don’t know how to best translate knowledge into action; we know how to prevent HIV, so why is the message not applied? We don’t know how to break the cycle of stigma? See? It’s a mystery. As much as I feel that HIV/AIDS deserves this kind of attention, I don’t want to dismiss the ways that individuals and organizations work to educate about HIV and advocate for themselves and others in the AIDS community, all without an array of CNN satellites and Anderson Cooper’s handsome but solemn mug. There may be something to dispelling an air of mystery and staying grounded. I’m thinking of David Burtka, this month’s cover story interview. As A&U’s Dann Dulin finds out, Burtka is vigilant about keeping the prevention message alive and strengthening our resolve to meet life’s challenges, as his family did when his mother was diagnosed with cancer and swiftly died. “Having the right mindset can overcome difficulties just with good thoughts,” he affirms. I’m thinking of advocates represented across the pages of this issue. Tim Courtney, Dudley Saunders, Traci Dinwiddie, and Tim Cummings all use various media to help get the word out about AIDS. Or check out our interview with Dr. Gary Blick, who, as an HIV care physician and a researcher working on gene-modified therapy that may provide a functional cure for those living with HIV/AIDS, has logged thirty-plus years and is still motivated to keep going. Finally, A&U’s Sean Black offers a portrait of Desert AIDS Project, another veteran in the fight. With innovative services, a constant eye on developing best practices, and helping to shape policy to protect our community, the non-profit is truly a rejuvenating spring that extends our lives. Maybe we don’t need an airplane after all. By staying grounded, we can take flight.

DAVID WAGGONER

Editor in Chief & Publisher David Waggoner Managing Editor: Michael Needle Senior Editor: Dann Dulin Editors at Large: Chip Alfred, Sean Black Special Projects Editor: Lester Strong Literary Editor: Brent Calderwood Consulting Editor: Nick Steele Copy Editor: Maureen Hunter Contributing Editors: Sarah Churchill Downes, Reed Massengill, Kelly McQuain, Lesléa Newman, Robert E. Penn Contributing Writers: Noël Alumit, V. Anderson, Annie Buckley, Larry Buhl, Ruby Comer, Nancy Ellegate, LaMont “Montee” Evans, Diane Goettel, Sally Hessney, Angela Leroux-Lindsey, Sherri Lewis, Alina Oswald, Mark Rebernik, Dale Reynolds, Elizabeth Rodgers, Mariel Selbovitz, Justin B. Terry-Smith, Patricia Nell Warren, Chuck Willman, Jeannie Wraight Art Director: Timothy J. Haines Contributing Photographers: Jordan Ancel, Davidd Batalon, Mark Bennington, Tom Bianchi, Sean Black, Adam Bouska, Brian Bowen Smith, Fred Brashear, Jr., Tim Courtney, Stephen Churchill Downes, Greg Gorman, Francis Hills, Renée Jacobs, Tom McGovern, Nancy Perry, Annie Tritt National Advertising Director: Harold Burdick, Jr. Sales & Marketing: David L. Bonitatibus Advertising Sales Office: (518) 426-9010 National Advertising Representative: Rivendell Media (212) 242-6863 Subscription Info: (518) 426-9010 Circulation Manager: Robert Schelepanow Bookkeeper: Richard Garcia Board of Directors President: David Waggoner Vice President: Harold Burdick, Jr. Secretary: Richard Garcia Founding Board Members: Mark S. Labrecque, 1961–1992, Christopher Hewitt, 1946–2004, Mark Galbraith, 1962–2011 In Memoriam: Bill Jacobson, 1939–2005 Rhomylly B. Forbes, 1963–2011 Chris Companik, 1957–2012 A&U (ISSN 1074-0872) is published by Art & Understanding, Inc., 25 Monroe St., Suite 205, Albany, NY 12210-2743, USA. For A&U advertising information please call 518-426-9010; for subscriptions and address changes please call 518-426-9010; for letters to the editor and unsolicited manuscripts write A&U Magazine, 25 Monroe Street, Albany, New York 12210; fax 518-436-5354; or e-mail: mailbox@ aumag.org. All unsolicited manuscripts that do not have a S.A.S.E. cannot be returned and will not be acknowledged. ©2014 Art & Understanding, Inc. ALL RIGHTS RESERVED. A&U may not be reproduced in any manner, either in whole or in part, without written permission of the publisher. A&U and the graphic representations thereof are the registered trademarks of Art & Understanding, Inc., a 501 (c) (3) nonprofit organization. Individual Subscription rates: $24.95 (12 issues). Institutional rates: $80.00 (12 issues). For subscriptions outside the USA and possessions, $30.95/Canada, $49.95/international, payable in advance in U.S. currency. First North American serial rights revert to contributors upon publication. A&U retains the right to anthologize work in further issues, as well as in microform or reprinting on the Internet within the context of each issue. Statements of writers, artists and advertisers are not necessarily those of the publisher. Readers note: subjects and contributors to A&U are both HIV-positive and HIV-negative. In the absence of a specific statement herein concerning the serostatus of any individual mentioned in, or contributing material to, this publication, no inference is made with respect thereto and none should be implied. Letters written to A&U or its contributors are assumed intended for publication. Art & Understanding, Inc. assumes no responsibility or liability for unsolicited submissions and does not guarantee the return thereof. PostMaster: Please send address corrections to A&U Magazine, 25 Monroe Street, Suite 205, Albany NY 12210-2743, USA

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A&U Mailbox

“...The African-American community is facing a huge crisis with AIDS gaining momentum. It is truly a crisis with all the statistics going way up for infection rates among blacks. This has to be stopped. I feel that Phill Wilson can change the course of AIDS among our people.”

Your article on Phill Wilson truly shows us the hero that he is in the fight against AIDS [cover story, “Watchdog,” by Sean Black, February 2014]. He has been involved with so many groups and founded that great organization, the Black AIDS Institute. His focus is correct: The African-American community is facing a huge crisis with AIDS gaining momentum. It is truly a crisis with all the statistics going way up for infection rates among blacks. This has to be stopped. I feel that Phill Wilson can change the course of AIDS among our people. Phill says, “We talk about an AIDS-free generation and we talk about ending the AIDS epidemic but we are not having specific conversations; a work plan. What do we need to do? When do we need to do it? And, who needs to do it? Right now we’re having all these theoretical and polemic conversations; enough talking already, let’s take action.” Great article. —Maldon Weatherby Opelika, Alabama I have a lot of respect for Phill Wilson. He is a trendsetter and a fighter to combat the AIDS epidemic in the Black population. He is to the point and focuses on what needs to be done. He has a great history in

trying to stop the disease of AIDS. We need more people like him. Instead of going up the statistics need to go the other way. We really do need a “Light At The End Of The Tunnel.” Phill Wilson will find that “Light.” —Clarissa Morton Runnemede, New Jersey

Affirming Ourselves I just loved reading the anthology, Cornbread, Fish and Collard Greens, by Khafre Kujichagulia Abif [“The Fierce Language of Self-Determination,” by Larry Buhl, February 2014]. I did find a lot of spirituality; it is like soul food for the body and the mind. The book is such a cross-section of different opinions, stories, feelings, love, happiness and sadness. As Khafre said it’s an anthology about people with AIDS, and people without AIDS. Everyone is included, no matter who they are. Come on, we need to get on board with this thinking—we are all affected by AIDS. Inclusion and not exclusion is the word. —Rondell Musgrove Emeryville, California

Walking Points

ity as a horrible thing. They need to see it in a different way. The story on Joseph Kibler by Alina Oswald [“A Walk to Remember,” February 2014] was an inspiration for me. What this young man can do is just amazing. He is HIV-positive and this does not let him down or steer him away from taking on challenges. In spite of his disability—I say, call it ability—he has managed to walk in the AIDS Walk LA. People need to stop looking down on disabled people. What Joseph Kibler can do many other people with AIDS or any other disease can do. Let’s stop labeling people in a negative way and focus on what we can do. —Sally Andrews Ketchum Holcomb, Kansas Send e-mail to: mailbox@aumag.org Send letters to: Mailbox, A&U, 25 Monroe Street, Suite 205, Albany, NY 12210 Or click on “Mailbox” on our Web site’s home page: www.aumag.org Tweet Us @au_magazine Facebook: http://on.fb.me/AUFANPAGE All correspondence requires name, address, and daytime phone number for confirmation. Letters may be edited for length and clarity.

People need to stop looking at disabilA&U • APRIL 2014

photo by Sean Black

Bright Light

NEWSBREAK Toast of the Town

photos courtesy M.A.C AIDS Fund

Thanks to presenting sponsor M•A•C Viva Glam, part of M•A•C Cosmetics, invitees gathered at Chateau Marmont in Hollywood to celebrate the six Oscar nominations garnered by Focus Features’ Dallas Buyers Club, an AIDSthemed movie about a determined effort to expand the treatment options for people living with AIDS during the early epidemic. The Nominees Toast, which was exclusively sponsored by M•A•C Viva Glam, helped raise a glass to the cast and crew of the movie—Matthew McConaughey (nominated for Best Actor), Jared Leto (Best Supporting Actor), Craig Borten and Melisa Wallack (Best Original Screenplay), and producers Robbie Brenner and Rachel Winter (Best Picture). The nominees were in attendance along with the film’s director Jean-Marc Vallée and costar Jennifer Garner, among others. (One day later, the film would take home awards for Best Actor and Best Supporting Top: Dallas Buyers Club’s Matthew McConaughey toasts with John Demsey, Group President of the Estée Actor, as well as Best Makeup and Hairstyling.) Since 1994, the M•A•C AIDS Fund has been raising awareness about AIDS Lauder Companies, and Karen Buglisi, Global Brand worldwide, educating the public, and providing services to all individuals living President of M·A·C Cosmetics, as others look on. with and affected by HIV/AIDS. The M•A•C Viva Glam lip product line takes Bottom: (Left to right) Oscar nominee Jared Leto, 100 percent of its selling price and forwards it directly to the M•A•C AIDS Fund. Demsey, Buglisi, and Oscar nominee McConaughey So far, its sales have raised more than $315 million. The organization “funds on the evening before both actors won in their innovative programs that deal directly with the most marginalized, stigmatized respective categories. and under-heard affected by HIV and AIDS,” according to one of its mission statements. At the pre-Oscars event, M•A•C announced grant awards totaling $100,000 for two vital organizations, whose services hew close to the themes of Dallas Buyers Club: Treatment Action Group (TAG) and AIDS Services of Dallas (ASD). • As an independent AIDS research and policy think tank, Treatment Action Group (TAG) strives to secure better and highly accessible treatment, care, and information, and is committed to promoting the search for an AIDS vaccine and cure. The $75,000 grant will be dedicated to TAG’s effort to identify gaps in care and treatment across the U.S., with a special emphasis on high-risk groups, as well as its effort to advocate for policy change to ensure treatment access. For more information, log on to: www.treatmentactiongroup.org. • AIDS Services of Dallas (ASD) nurtures the communities for which it provides services, working to deliver affordable and service-enriched housing for individuals and families living with HIV/AIDS. The grant of $25,000 will help ASD provide direct services that serve as a foundation for individuals to access stable and continuous treatment and care. For more information, log on to: www.aidsdallas.org. To learn more about the M•A•C AIDS Fund, visit: www.macaidsfund.org.

No Longer Top 10 In 2011, AIDS-related complications were ninth on New York City’s top ten causes of death. In 2011, AIDS accounted for 766 deaths; by the following year, the number dropped to 609. Based on 2012 data, AIDS has now dropped off the list, accordAPRIL 2014 • A&U

ABOUT PREZISTA

PREZISTA® is always taken with and at the same time as ritonavir (Norvir ®), in combination with other HIV medicines for the treatment of HIV infection in adults. PREZISTA® should also be taken with food. • The use of other medicines active against HIV in combination with PREZISTA®/ritonavir (Norvir ®) may increase your ability to fight HIV. Your healthcare professional will work with you to find the right combination of HIV medicines • It is important that you remain under the care of your healthcare professional during treatment with PREZISTA® PREZISTA® does not cure HIV infection or AIDS and you may continue to experience illnesses associated with HIV-1 infection, including opportunistic infections. You should remain under the care of a doctor when using PREZISTA.® Please read Important Safety Information below, and talk to your healthcare professional to learn if PREZISTA® is right for you.

IMPORTANT SAFETY INFORMATION What is the most important information I should know about PREZISTA®? • PREZISTA® can interact with other medicines and cause serious side effects. See “Who should not take PREZISTA®?” • PREZISTA® may cause liver problems. Some people taking PREZISTA,® together with Norvir ® (ritonavir), have developed liver problems which may be life-threatening. Your healthcare professional should do blood tests before and during your combination treatment with PREZISTA.® If you have chronic hepatitis B or C infection, your healthcare professional should check your blood tests more often because you have an increased chance of developing liver problems • Tell your healthcare professional if you have any of these signs and symptoms of liver problems: dark (tea-colored) urine, yellowing of your skin or whites of your eyes, pale-colored stools (bowel movements), nausea, vomiting, pain or tenderness on your right side below your ribs, or loss of appetite • PREZISTA® may cause a severe or life-threatening skin reaction or rash. Sometimes these skin reactions and skin rashes can become severe and require treatment in a hospital. You should call your healthcare professional immediately if you develop a rash. However, stop taking PREZISTA® and ritonavir combination treatment and call your healthcare professional immediately if you develop any skin changes with these symptoms: fever, tiredness, muscle or joint pain, blisters or skin lesions, mouth sores or ulcers, red or inflamed eyes, like “pink eye.” Rash occurred more often in patients taking PREZISTA® and raltegravir together than with either drug separately, but was generally mild Who should not take PREZISTA®? • Do not take PREZISTA® if you are taking the following medicines: alfuzosin (Uroxatral®), dihydroergotamine (D.H.E.45,® Embolex,® Migranal®), ergonovine, ergotamine (Cafergot,® Ergomar ®), methylergonovine, cisapride (Propulsid®), pimozide (Orap®), oral midazolam, triazolam (Halcion®), the herbal supplement St. John’s wort (Hypericum perforatum), lovastatin (Mevacor,® Altoprev,® Advicor ®), simvastatin (Zocor,® Simcor,® Vytorin®), rifampin (Rifadin,® Rifater,®

Rifamate,® Rimactane®), sildenafil (Revatio®) when used to treat pulmonary arterial hypertension, indinavir (Crixivan®), lopinavir/ ritonavir (Kaletra®), saquinavir (Invirase®), boceprevir (Victrelis™), or telaprevir (Incivek™) • Before taking PREZISTA,® tell your healthcare professional if you are taking sildenafil (Viagra,® Revatio®), vardenafil (Levitra,® Staxyn®), tadalafil (Cialis,® Adcirca®), atorvastatin (Lipitor ®), rosuvastatin (Crestor ®), pravastatin (Pravachol®), or colchicine (Colcrys,® Col-Probenecid®). Tell your healthcare professional if you are taking estrogen-based contraceptives (birth control). PREZISTA® might reduce the effectiveness of estrogen-based contraceptives. You must take additional precautions for birth control, such as condoms This is not a complete list of medicines. Be sure to tell your healthcare professional about all the medicines you are taking or plan to take, including prescription and nonprescription medicines, vitamins, and herbal supplements. What should I tell my doctor before I take PREZISTA®? • Before taking PREZISTA,® tell your healthcare professional if you have any medical conditions, including liver problems (including hepatitis B or C), allergy to sulfa medicines, diabetes, or hemophilia • Tell your healthcare professional if you are pregnant or planning to become pregnant, or are breastfeeding — The effects of PREZISTA® on pregnant women or their unborn babies are not known. You and your healthcare professional will need to decide if taking PREZISTA® is right for you — Do not breastfeed. It is not known if PREZISTA® can be passed to your baby in your breast milk and whether it could harm your baby. Also, mothers with HIV should not breastfeed because HIV can be passed to your baby in the breast milk What are the possible side effects of PREZISTA®? • High blood sugar, diabetes or worsening of diabetes, and increased bleeding in people with hemophilia have been reported in patients taking protease inhibitor medicines, including PREZISTA® • Changes in body fat have been seen in some patients taking HIV medicines, including PREZISTA.® The cause and long-term health effects of these conditions are not known at this time • Changes in your immune system can happen when you start taking HIV medicines. Your immune system may get stronger and begin to fight infections that have been hidden • The most common side effects related to taking PREZISTA® include diarrhea, nausea, rash, headache, stomach pain, and vomiting. This is not a complete list of all possible side effects. If you experience these or other side effects, talk to your healthcare professional. Do not stop taking PREZISTA® or any other medicines without first talking to your healthcare professional You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. Please refer to the ritonavir (Norvir ®) Product Information (PI and PPI) for additional information on precautionary measures. Please read accompanying Patient Information for PREZISTA® and discuss any questions you have with your doctor.

28PRZDTC0288R8

PREZISTA® (darunavir) is a prescription medicine. It is one treatment option in the class of HIV (human immunodeficiency virus) medicines known as protease inhibitors.

ily a D e c n O

Once-Daily PREZISTA® (darunavir) taken with ritonavir and in combination with other HIV medications can help lower your viral load and keep your HIV under control. The PREZISTA® Experience isn’t just an HIV treatment. It’s an HIV treatment experience as unique as you. Find out if the PREZISTA® Experience is right for you. Ask your healthcare professional and learn more at PREZISTA.com

Snap a quick pic of our logo to show your doctor and get the conversation started.

Please read the Important Safety Information and Patient Information on adjacent pages.

Janssen Therapeutics, Division of Janssen Products, LP © Janssen Therapeutics, Division of Janssen Products, LP 2014 01/14 006960-131202

IMPORTANT PATIENT INFORMATION PREZISTA (pre-ZIS-ta) (darunavir) Oral Suspension PREZISTA (pre-ZIS-ta) (darunavir) Tablets Read this Patient Information before you start taking PREZISTA and each time you get a refill. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or your treatment. Also read the Patient Information leaflet for NORVIR® (ritonavir). What is the most important information I should know about PREZISTA? • PREZISTA can interact with other medicines and cause serious side effects. It is important to know the medicines that should not be taken with PREZISTA. See the section “Who should not take PREZISTA?” • PREZISTA may cause liver problems. Some people taking PREZISTA in combination with NORVIR® (ritonavir) have developed liver problems which may be life-threatening. Your healthcare provider should do blood tests before and during your combination treatment with PREZISTA. If you have chronic hepatitis B or C infection, your healthcare provider should check your blood tests more often because you have an increased chance of developing liver problems. • Tell your healthcare provider if you have any of the below signs and symptoms of liver problems. • Dark (tea colored) urine • yellowing of your skin or whites of your eyes • pale colored stools (bowel movements) • nausea • vomiting • pain or tenderness on your right side below your ribs • loss of appetite PREZISTA may cause severe or life-threatening skin reactions or rash. Sometimes these skin reactions and skin rashes can become severe and require treatment in a hospital. You should call your healthcare provider immediately if you develop a rash. However, stop taking PREZISTA and ritonavir combination treatment and call your healthcare provider immediately if you develop any skin changes with symptoms below: • fever • tiredness • muscle or joint pain • blisters or skin lesions • mouth sores or ulcers • red or inflamed eyes, like “pink eye” (conjunctivitis) Rash occurred more often in people taking PREZISTA and raltegravir together than with either drug separately, but was generally mild. See “What are the possible side effects of PREZISTA?” for more information about side effects. What is PREZISTA? PREZISTA is a prescription anti-HIV medicine used with ritonavir and other anti-HIV medicines to treat adults with human immunodeficiency virus (HIV-1) infection. PREZISTA is a type of anti-HIV medicine called a protease inhibitor. HIV is the virus that causes AIDS (Acquired Immune Deficiency Syndrome). When used with other HIV medicines, PREZISTA may help to reduce the amount of HIV in your blood (called “viral load”). PREZISTA may also help to increase the number of white blood cells called CD4 (T) cell which help fight off other infections. Reducing the amount of HIV and increasing the CD4 (T) cell count may improve your immune system. This may reduce your risk of death or infections that can happen when your immune system is weak (opportunistic infections). PREZISTA does not cure HIV infection or AIDS and you may continue to experience illnesses associated with HIV-1 infection, including opportunistic infections. You should remain under the care of a doctor when using PREZISTA. Avoid doing things that can spread HIV-1 infection. • Do not share needles or other injection equipment. • Do not share personal items that can have blood or body fluids on them, like toothbrushes and razor blades.

• D o not have any kind of sex without protection. Always practice safe sex by using a latex or polyurethane condom to lower the chance of sexual contact with semen, vaginal secretions, or blood. Ask your healthcare provider if you have any questions on how to prevent passing HIV to other people. Who should not take PREZISTA? Do not take PREZISTA with any of the following medicines: • alfuzosin (Uroxatral®) • dihydroergotamine (D.H.E. 45®, Embolex®, Migranal®), ergonovine, ergotamine (Cafergot®, Ergomar®) methylergonovine • cisapride • pimozide (Orap®) • oral midazolam, triazolam (Halcion®) • the herbal supplement St. John’s Wort (Hypericum perforatum) • the cholesterol lowering medicines lovastatin (Mevacor®, Altoprev®, Advicor®) or simvastatin (Zocor®, Simcor®, Vytorin®) • rifampin (Rifadin®, Rifater®, Rifamate®, Rimactane®) • sildenafil (Revatio®) only when used for the treatment of pulmonary arterial hypertension. Serious problems can happen if you take any of these medicines with PREZISTA. What should I tell my doctor before I take PREZISTA? PREZISTA may not be right for you. Before taking PREZISTA, tell your healthcare provider if you: • have liver problems, including hepatitis B or hepatitis C • are allergic to sulfa medicines • have high blood sugar (diabetes) • have hemophilia • are pregnant or planning to become pregnant. It is not known if PREZISTA will harm your unborn baby. Pregnancy Registry: You and your healthcare provider will need to decide if taking PREZISTA is right for you. If you take PREZISTA while you are pregnant, talk to your healthcare provider about how you can be included in the Antiretroviral Pregnancy Registry. The purpose of the registry is follow the health of you and your baby. • are breastfeeding or plan to breastfeed. Do not breastfeed. We do not know if PREZISTA can be passed to your baby in your breast milk and whether it could harm your baby. Also, mothers with HIV-1 should not breastfeed because HIV-1 can be passed to the baby in the breast milk. Tell your healthcare provider about all the medicines you take including prescription and nonprescription medicines, vitamins, and herbal supplements. Using PREZISTA and certain other medicines may affect each other causing serious side effects. PREZISTA may affect the way other medicines work and other medicines may affect how PREZISTA works. Especially tell your healthcare provider if you take: • other medicine to treat HIV • estrogen-based contraceptives (birth control). PREZISTA might reduce the effectiveness of estrogen-based contraceptives. You must take additional precautions for birth control such as a condom. • medicine for your heart such as bepridil, lidocaine (Xylocaine Viscous®), quinidine (Nuedexta®), amiodarone (Pacerone®, Cardarone®), digoxin (Lanoxin®), flecainide (Tambocor®), propafenone (Rythmol®) • warfarin (Coumadin®, Jantoven®) • medicine for seizures such as carbamazepine (Carbatrol®, Equetro®, Tegretol®, Epitol®), phenobarbital, phenytoin (Dilantin®, Phenytek®) • medicine for depression such as trazadone and desipramine (Norpramin®) • clarithromycin (Prevpac®, Biaxin®) • medicine for fungal infections such as ketoconazole (Nizoral®), itraconazole (Sporanox®, Onmel®), voriconazole (VFend®) • colchicine (Colcrys®, Col-Probenecid®) • rifabutin (Mycobutin®) • medicine used to treat blood pressure, a heart attack, heart failure, or to lower pressure in the eye such as metoprolol (Lopressor®, Toprol-XL®), timolol (Cosopt®, Betimol®, Timoptic®, Isatolol®, Combigan®) • midazolam administered by injection • medicine for heart disease such as felodipine (Plendil®), nifedipine (Procardia®, Adalat CC®, Afeditab CR®), nicardipine (Cardene®) • steroids such as dexamethasone, fluticasone (Advair Diskus®, Veramyst®, Flovent®, Flonase®) • bosentan (Tracleer®) • medicine to treat chronic hepatitis C such as boceprevir (VictrelisTM), telaprevir (IncivekTM)

IMPORTANT PATIENT INFORMATION • m edicine for cholesterol such as pravastatin (Pravachol®), atorvastatin (Lipitor®), rosuvastatin (Crestor®) • medicine to prevent organ transplant failure such as cyclosporine (Gengraf®, Sandimmune®, Neoral®), tacrolimus (Prograf®), sirolimus (Rapamune®) • salmeterol (Advair®, Serevent®) • medicine for narcotic withdrawal such as methadone (Methadose®, Dolophine Hydrochloride), buprenorphine (Butrans®, Buprenex®, Subutex®), buprenorphine/naloxone (Suboxone®) • medicine to treat schizophrenia such as risperidone (Risperdal®), thioridazine • medicine to treat erectile dysfunction or pulmonary hypertension such as sildenafil (Viagra®, Revatio®), vardenafil (Levitra®, Staxyn®), tadalafil (Cialis®, Adcirca®) • medicine to treat anxiety, depression or panic disorder such as sertraline (Zoloft®), paroxetine (Paxil®, Pexeva®) • medicine to treat malaria such as artemether/lumefantrine (Coartem®) This is not a complete list of medicines that you should tell your healthcare provider that you are taking. Ask your healthcare provider or pharmacist if you are not sure if your medicine is one that is listed above. Know the medicines you take. Keep a list of them to show your doctor or pharmacist when you get a new medicine. Do not start any new medicines while you are taking PREZISTA without first talking with your healthcare provider. How should I take PREZISTA? • Take PREZISTA every day exactly as prescribed by your healthcare provider. • You must take ritonavir (NORVIR®) at the same time as PREZISTA. • Do not change your dose of PREZISTA or stop treatment without talking to your healthcare provider first. • Take PREZISTA and ritonavir (NORVIR®) with food. • Swallow PREZISTA tablets whole with a drink. If you have difficulty swallowing PREZISTA tablets, PREZISTA oral suspension is also available. Your health care provider will help decide whether PREZISTA tablets or oral suspension is right for you. • PREZISTA oral suspension should be given with the supplied oral dosing syringe. Shake the suspension well before each use. See the Instructions for Use that come with PREZISTA oral suspension for information about the right way to prepare and take a dose. • If your prescribed dose of PREZISTA oral suspension is more than 6 mL, you will need to divide the dose. Follow the instructions given to you by your healthcare provider or pharmacist about how to divide the dose. Ask your healthcare provider or pharmacist if you are not sure. • If you take too much PREZISTA, call your healthcare provider or go to the nearest hospital emergency room right away. What should I do if I miss a dose? People who take PREZISTA one time a day: • If you miss a dose of PREZISTA by less than 12 hours, take your missed dose of PREZISTA right away. Then take your next dose of PREZISTA at your regularly scheduled time. • If you miss a dose of PREZISTA by more than 12 hours, wait and then take the next dose of PREZISTA at your regularly scheduled time. People who take PREZISTA two times a day • If you miss a dose of PREZISTA by less than 6 hours, take your missed dose of PREZISTA right away. Then take your next dose of PREZISTA at your regularly scheduled time. • If you miss a dose of PREZISTA by more than 6 hours, wait and then take the next dose of PREZISTA at your regularly scheduled time. If a dose of PREZISTA is skipped, do not double the next dose. Do not take more or less than your prescribed dose of PREZISTA at any one time. What are the possible side effects of PREZISTA? PREZISTA can cause side effects including: • See “What is the most important information I should know about PREZISTA?” • Diabetes and high blood sugar (hyperglycemia). Some people who take protease inhibitors including PREZISTA can get high blood sugar, develop diabetes, or your diabetes can get worse. Tell your healthcare provider if you notice an increase in thirst or urinate often while taking PREZISTA. • Changes in body fat. These changes can happen in people who take antiretroviral therapy. The changes may include an increased amount of fat in the upper back and neck (“buffalo hump”), breast, and around the back, chest, and stomach area. Loss of fat from the legs, arms, and face may also happen. The exact cause and longterm health effects of these conditions are not known.

• Changes in your immune system (Immune Reconstitution Syndrome) can happen when you start taking HIV medicines. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Call your healthcare provider right away if you start having new symptoms after starting your HIV medicine. • Increased bleeding for hemophiliacs. Some people with hemophilia have increased bleeding with protease inhibitors including PREZISTA. The most common side effects of PREZISTA include: • diarrhea • headache • nausea • abdominal pain • rash • vomiting Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all of the possible side effects of PREZISTA. For more information, ask your health care provider. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. How should I store PREZISTA? • Store PREZISTA oral suspension and tablets at room temperature [77°F (25°C)]. • Do not refrigerate or freeze PREZISTA oral suspension. • Keep PREZISTA away from high heat. • PREZISTA oral suspension should be stored in the original container. Keep PREZISTA and all medicines out of the reach of children. General information about PREZISTA Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use PREZISTA for a condition for which it was not prescribed. Do not give PREZISTA to other people even if they have the same condition you have. It may harm them. This leaflet summarizes the most important information about PREZISTA. If you would like more information, talk to your healthcare provider. You can ask your healthcare provider or pharmacist for information about PREZISTA that is written for health professionals. For more information, call 1-800-526-7736. What are the ingredients in PREZISTA? Active ingredient: darunavir Inactive ingredients: PREZISTA Oral Suspension: hydroxypropyl cellulose, microcrystalline cellulose, sodium carboxymethylcellulose, methylparaben sodium, citric acid monohydrate, sucralose, masking flavor, strawberry cream flavor, hydrochloric acid (for pH adjustment), purified water. PREZISTA 75 mg and 150 mg Tablets: colloidal silicon dioxide, crospovidone, magnesium stearate, microcrystalline cellulose. The film coating contains: OPADRY® White (polyethylene glycol 3350, polyvinyl alcohol-partially hydrolyzed, talc, titanium dioxide). PREZISTA 400 mg and 600 mg Tablets: colloidal silicon dioxide, crospovidone, magnesium stearate, microcrystalline cellulose. The film coating contains: OPADRY® Orange (FD&C Yellow No. 6, polyethylene glycol 3350, polyvinyl alcohol-partially hydrolyzed, talc, titanium dioxide). PREZISTA 800 mg Tablets: colloidal silicon dioxide, crospovidone, magnesium stearate, microcrystalline cellulose, hypromellose. The film coating contains: OPADRY® Dark Red (iron oxide red, polyethylene glycol 3350, polyvinyl alcohol-partially hydrolyzed, talc, titanium dioxide). This Patient Information has been approved by the U.S Food and Drug Administration. Product of Ireland Manufactured by: PREZISTA Oral Suspension PREZISTA Tablets Janssen Pharmaceutica, N.V. Janssen Ortho LLC, Beerse, Belgium Gurabo, PR 00778 Manufactured for: Janssen Therapeutics, Division of Janssen Products, LP, Titusville NJ 08560 Revised: December 2013 NORVIR® is a registered trademark of its respective owner. PREZISTA® is a registered trademark of Janssen Pharmaceuticals © Janssen Pharmaceuticals, Inc. 2006 007653-131217

NewsBreak

ing to New York City Health Commissioner Mary Bassett. It’s the first time in thirty years that AIDS has not made the list, which places heart disease as number one, followed by cancer, influenza, pneumonia, diabetes and chronic respiratory diseases. AIDS-related deaths in New York City have been steadily declining, with only small spikes, from a peak in the mid-nineties, when antiretrovirals were first becoming widely available. Still, the number of individuals living with AIDS in New York City has steadily increased since the early 1980s and has one of the highest AIDS case rates in the country. Over 3,000 New Yorkers were diagnosed with HIV in 2012, according to the most recent reporting. Improved treatments, dosing and adherence, access, and long-term survival in general, were in part responsible for the top-ten change, according to New York City health officials.

Syringe Access Fifty new grants, totaling $2.3 million, have been awarded by The Syringe Access Fund (SAF), a collaborative funding initiative of the Elton John AIDS Foundation, Levi Strauss Foundation, Open Society Foundations, Irene Diamond Fund, Tides Foundation, and AIDS United. The grantees include dedicated organizations and programs across the nation and in U.S. territories: AIDS Taskforce of Greater Cleveland, Ohio; Blue Mountain Heart to Heart, Washington; El Punto en la Montaña, Puerto Rico; Needle Exchange Emergency Distribution (Berkeley NEED), California; Prevention Point Pittsburgh, Pennsylvania; Voices Of Community Activists & Leaders (VOCAL-NY), New York, among others. Underserved populations and areas with a high prevalence of HIV/AIDS and injection drug use were prioritized. Created in 2004, SAF has become the country’s largest private supporter of syringe exchange programs (SEPs). It was launched to ensure and expand sterile syringe exchange and to promote sound public policies in an effort to reduce the infection risk of HIV, hepatitis C and other blood-borne pathogens among injection drug users and their sexual partners. Evidence shows that SEPs significantly reduce transmission of HIV, hepatitis C and other blood-borne illnesses, without promoting drug use. For more information on the Syringe Access Fund, contact Vignetta Charles, AIDS United Senior Vice President, by e-mail at vcharles@aidsunited.org, or by phone at (202) 408-4848, ext 218.

Light-Up New York!

photo by Chael Needle

The New York City skyline at night attracts both tourists and residents alike with its glittery presence. A new AIDS Walk NY initiative called Light-Up New York! is calling for businesses and buildings to light up in red during the week leading up to the Walk, which will take place on May 18. AIDS Walk NY pulls together New York City and other communities in an effort to raise funds for GMHC and over forty AIDS service organizations in the tri-state area, reduce stigma, and raise awareness about HIV/AIDS. Osvaldo Perdomo, who, as an artist and advocate, has been featured many times in the pages of A&U, shares how the light bulb for Light-Up New York! came about: “I came up with this idea thinking about what could I do as an active member of GMHC Board of Directors and a man living with the virus, to help the AIDS Community and to send a strong message to millions of New Yorkers that AIDS is not over during AIDS Walk New York. “I want to shake up New York sending a strong message: AIDS is not over. I want this message to capture national attention as well as to other parts of the world. I want people to realize that thousands of people are getting infected with HIV/AIDS today. I want people to realize taking one pill a day is not a reality for everyone living with HIV/AIDS. I want people to realize that there are many side effects coming from HIV/AIDS. I want people to realize that treating HIV/AIDS is very expensive. I want people to realize that stigma is still a problem. I want people to realize even though we have advancements in medical care, the truth of the matter is that effective medical treatment and the necessary financial support is not available to help all people living in the United States who are affected with HIV/AIDS. It is sad, but true. AIDS is not over and we need our community to be alert until we find a cure.” He continues: “This year marks AIDS Walk New York’s twenty-ninth anniversary. This is my fifth year walking and fundraising again after my AIDS diagnosis in 2004. Through these five years actively involved with the AIDS Walk, I have noticed a lack of urgency towards HIV/AIDS. However, when you go inside of GMHC or any other AIDS service organization, anyone can witness the needs are still there and the urgency for help and support persists among many people living with the virus. People with HIV/AIDS need connection to effective medical care, psychological support, proper meals and nutrition, legal service, housing support, and we need comprehensive solutions to promote education, prevention and increase awareness to build supportive and stronger communities.” The initiative has already enlisted the Empire State Building, One World Trade Center, Seven World Trade Center, The Bloomberg Tower, Time Warner Cable, and JFK Airport Tower, among others. For more information (or to help Light-Up New York!), contact Andi Dubé, Promotions Coordinator, by e-mail at AndiD@aidswalk.net or by phone at (212) 807-9255 (WALK).

A&U • APRIL 2014

Bringing hearts together since 1998

P zMatch.c m

poetry

Memorial Quilt by Michelle Perez

The last time we kissed our friend, was in upstate New York. She lived off a patch of gravel-strewn lane where willows overhang the road’s shoulder and the light’s raked retreat can mask subtle patterns ahead: a scrap of lawn, hoarfrost, the taut chill of breath. Where, slowly, silver branches switch and set offering blazed, left over leaves as fodder. But who can afford not to dwell, at least once, where green becomes shelter, flourishes, then fades? We tried to convince her, come back to the city, but she was as silent as the forewarned crickets and receded, sweet crocus, to haunt our prayers: Rose de chine, turtle dove…lover’s knot…she turned away, her gaunt face still harboring quick slants of light and honey-slate curls: compass, sunburst, crazy star, wine, oh! unstitched weave of colors, still. —Michelle Perez Michelle Perez was a James Michener Fellow at the University of Miami. Her poems have appeared in THEMA, Earth’s Daughters, and other literary journals.

A&U • APRIL 2014

DRIVE OUT AIDS WIN A CAR RAFFLE THIS 2014 KIA FORTE CAN BE YOURS FOUR WAYS TO ENTER

By Phone 213-353-3610 x107 By Fax 213-402-7217 By Email AIDSraffle@BlackAIDS.org By Mail 1833 W. 8th St., L.A. CA 90057

www.AIDSraffle.org Kia Forte courtesy of Car Pros Kia of Carson

TIM COURTNEY

Ruby Comer: Tim, do you remember

when you first heard about the epidemic? Tim Courtney: It was probably in 1983 when I was in college. I really wasn’t educated about it, other than it was something to do with sex, and that men were dying from it. I remember the first man I allowed to penetrate me—without a condom. I later found out that he had a wife. In all honesty, I didn’t know that a guy could put his penis into my anus until this man did and I had no idea what a condom was used for. A year later I was informed that he had AIDS, was in the hospital and dying. I well remember my mind going beyond the fear and straight to feeling numb and disconnected with everything in life. To give you an idea of how it affected me, I had received this information early on a Sunday evening. I went to sleep that Sunday night and arose from bed to go to class the next morning, only to find out when I arrived at class it was Tuesday morning. I had slept from Sunday night to Tuesday morning. Wow, that knocked you for a loop, boy! Of course…. I’ve lost many friends to this epidemic and did help take care of a few, especially my former partner’s good friend, Danny. Memories come up of things I did to help him achieve his last dream before passing: to maintain some dignity and still feel like he was an attractive man. [Tim becomes very quiet, reflecting.] I can think of so many who passed too soon before the cocktail medications came out. They were so young; many were in their early thirties. As you know Ruby, my first partner Greg,

who had once been your boyfriend, passed away in the early 2000’s from AIDS. I heard about Greg. What a fun time the four of us (my fiancé Rudy) had that one New Year’s Eve in Palm Springs, huh?! After your diagnosis how did it affect you? The first year was horrible, everyone was dying, and my spirit was dying on the inside. About a year after my diagnosis, while I was songwriting and in a severe drama of imminent self-pity, it occurred to me that I was still alive. I took back my life that day realizing I might be alive even another year. Did I want to spend it the way I had just spent the last year? How did you discover you were positive? About two months prior to my next HIV testing, I contracted a severe flu. People used to ask, “Who do you think gave

ruby illustration by Davidd Batalon; photo by Tim Courtney

“R

uby, do you want to play doctor? This time let me be the doctor, okay?” This childhood memory flashes through my noggin’ when I see an old chum, Tim Courtney, at an AIDS fundraiser in San Diego. Tim and I used to be neighbors and one time during middle school, he accompanied me to the Sadie Hawkins dance. But before high school, he and his family moved away and I lost track of him. We hooked up again in Los Angeles in the nineties when an old boyfriend of mine, Greg, started dating him. Yes, I drove Greg gay! I learned then that Tim was a photographer so I connected him with A&U magazine, where he shot many covers. For nearly fifteen years we haven’t been in contact. After the event, Tim invites me to his charming Hillcrest apartment and we catch up. He has been HIV-positive since 1990 and, fortunately, has had no AIDS-related illnesses. Over the years he’s been an active volunteer, dedicating many hours to Los Angeles’ Project Angel Food (“I enjoyed working there and still use a recipe of theirs, pineapple sour cream pie!”). Several years ago he established his own nonprofit organization, Picture Me Happy, helping children who are afflicted with terminal illnesses. Tim has been to hell and back with addiction; however, he’s been sober for nearly ten years. He offers to share his story since he feels it might help others, so straight away I pull out my trusty digital recorder from my cherry Fossil handbag. We huddle together on his balcony that overlooks a low-lit urban street and we bask in the bright glow of the dazzling la luna above.

A&U • APRIL 2014

it to you?” My response is still the same, “What does it matter? What does it have to do with who it was? I was the one who was there, with my low-self esteem and compulsive decision for bare sex. Indeed. What medical treatment did you seek? I have to tell you, Ruby, my very first doctor gave me the best advice ever. He said, “Do what you believe is right for you.” I waited till the first cocktail drugs came out before taking anything. My belief was and still is today, quality of life versus severe side effects and longevity of life. I quickly learned that my little body could not handle the regular dosages, so I made an adjustment. I take only about a third to a half of what is prescribed. Through the years I have also taken five or six-month breaks from medications in order to clean out my system. I don’t recommend it to others, but this has been my experience.

very healthy, most of the time, though as you know Ruby, I love my sweets! Join the club, Tim! What inspired you to found your organization Picture Me Happy? I wanted greater fulfillment in life. I began volunteering my photography services at Los Angeles Children’s Hospital. I saw a real need for the creative project I was offering to the children. They were engaged with the creative process and it got them into the playrooms. It also worked well for those who were at bedside. What year was it established and tell me what it does exactly. It was created in 2007. Picture Me Happy inspires the healing process through creative arts for hospitalized children with serious medical conditions, such as cancer, leukemia, AIDS, sickle cell, pulmonary disease, and other chronic

I’ve always believed that everyone needs to do what is best for them, not just what a professional advises. It’s so easy to sit back, be told what to do, and not take any responsibility. So easy…. I think it works well if you believe it does. [I nod.] And the monitoring test can be good proof to back it up. I’m currently on a one-pill regimen of Stribild. I take half every night before bedtime, along with 1,000 mg of Vitamin C. I also take 1,000 mg of Vitamin C twice a day, and always one along with my HIV meds. Fortunately, I continue to have excellent numbers.

and terminal illnesses. We currently serve children’s hospitals in Long Beach and San Diego. And we’ll soon be expanding a number of programs, adding more variety and activities for children and teens.

YEAH! [We hug.] Do you do anything else alternative? I am a big fan of Zyflamend, a 100-percent pure fish oil pill, and Holy Basil, all made by the company New Chapter. When needed, I take liquid silver, a natural antibiotic. I find it helps with sinus infections and allergies. I work out to keep the body active and lively. I’ve been working out in the gym with both weights and cardio since I was nineteen years-old. Exercising has absolutely made a positive difference in many areas of my life, and continues to do so. I also eat

What motivates you to continually offer yourself to others? Oops, maybe I should ask that in another way. [We both cackle hysterically.] I have learned that I have a choice to work on the solution or to be a part of the problem. I used to cry watching commercials showing children and adults going through horrible life circumstances. I cried and whined, but I didn’t bother to be active. [He declares in an assertive voice:] Get into the solution and help better the situation! I realized my crying and sadness

APRIL 2014 • A&U

had a lot to do with me, not them. I can’t help everyone, but when I choose one [an organization], I’m working alongside millions of other caring people who are helping to create a better world together. Ya know, my friend, I want to know more about your addiction. Oh my…First of all, this isn’t me being very anonymous [according to AA rules one needs to remain nameless], but I hope this will be of benefit to someone. I spent eight years of my life committed to meth, and lots of alcohol before that. I say committed, because it got to a point where I couldn’t not do it. As those using years passed, I was dying more and more on the inside and looking like death on the outside. The bottom for me was a Thanksgiving evening when I didn’t show up at a friend’s big dinner. I was in my apartment on my bed, convulsing, while a friend was on-line looking for his next trick. Ignoring my flipping around all over my bed, he left me, but with a big bag of drugs to help. I knew I needed to get to a hospital; I was going to die. It seems I was about to get what I wanted…the final escape. Here I was finally going to get out of this life that was too hard and painful for me to live in. But…I really didn’t want to die. [As an afterthought, Tim laments with a chuckle:] My goals and dreams had never included, “I want to be an alcoholic or an addict!” So what happened next? I woke the next morning and admitted to myself, “I…need…help.” Very weak and degraded, I got myself dressed and drove to a noon NA [Narcotics Anonymous] meeting in West Hollywood. With gratitude, Ruby, I persevere in my recovery to this day. I discovered a life worth living. For more information, visit TimCourtneyphotography.com and PictureMeHappy.org. Ruby Comer is an independent journalist from the Midwest who is happy to call Hollywood her home away from home. Reach her by e-mail at MsRubyComer@aol.com.

COMPLERA is a prescription medicine used as a complete HIV-1 treatment in 1 pill a day. It is for adults who have never taken HIV-1 medicines before and who have no more than 100,000 copies/mL of virus in their blood. COMPLERA can also replace current HIV-1 medicines for some adults who have an undetectable viral load (less than 50 copies/mL) and whose healthcare provider determines that they meet certain other requirements. COMPLERA does not cure HIV-1 or AIDS.

Just the

one

for me

COMPLERA is a complete HIV-1 treatment in only 1 pill a day. Ask your healthcare provider if COMPLERA may be the one for you.

Pill shown is not actual size.

What is COMPLERA?

COMPLERA (emtricitabine 200 mg, rilpivirine 25 mg, tenofovir disoproxil fumarate 300 mg) is a prescription medicine used as a complete HIV-1 treatment in one pill a day. COMPLERA is for adults who have never taken HIV-1 medicines before and who have no more than 100,000 copies/mL of virus in their blood (this is called ‘viral load’). COMPLERA can also replace current HIV-1 medicines for some adults who have an undetectable viral load (less than 50 copies/mL) and whose healthcare provider determines that they meet certain other requirements. COMPLERA combines 3 medicines into 1 pill to be taken once a day with food. COMPLERA is a complete single tablet regimen and should not be used with other HIV-1 medicines. It is not known if COMPLERA is safe and effective in children under the age of 18 years. COMPLERA does not cure HIV-1 infection or AIDS. To control HIV-1 infection and decrease HIV-related illnesses you must keep taking COMPLERA. Ask your healthcare provider if you have questions about how to reduce the risk of passing HIV-1 to others. Always practice safer sex and use condoms to lower the chance of sexual contact with body fluids. Never reuse or share needles or other items that have body fluids on them.

IMPORTANT SAFETY INFORMATION What is the most important information I should know about COMPLERA?

COMPLERA can cause serious side effects: • Build-up of an acid in your blood (lactic acidosis), which is a serious medical emergency. Symptoms of lactic acidosis include feeling very weak or tired, unusual (not normal) muscle pain, trouble breathing, stomach pain with nausea or vomiting, feeling cold especially in your arms and legs, feeling dizzy or lightheaded, and/or a fast or irregular heartbeat. • Serious liver problems. The liver may become large (hepatomegaly) and fatty (steatosis). Symptoms of liver problems include your skin or the white part of your eyes turns yellow (jaundice), dark “tea-colored” urine, light-colored bowel movements (stools), loss of appetite for several days or longer, nausea, and/or stomach pain. • You may be more likely to get lactic acidosis or serious liver problems if you are female, very overweight (obese), or have been taking COMPLERA for a long time. In some cases, these serious conditions have led to death. Call your healthcare provider right away if you have any symptoms of these conditions. • Worsening of hepatitis B (HBV) infection. If you also have HBV and stop taking COMPLERA, your hepatitis may suddenly get worse. Do not stop taking COMPLERA without first talking to your healthcare provider, as they will need to monitor your health. COMPLERA is not approved for the treatment of HBV.

Who should not take COMPLERA?

Do not take COMPLERA if you: • Take a medicine that contains: carbamazepine (Carbatrol, Equetro, Tegretol, Tegretol-XR, Teril, Epitol), oxcarbazepine (Trileptal), phenobarbital (Luminal), phenytoin (Dilantin, Dilantin-125, Phenytek), rifabutin (Mycobutin), rifampin (Rifater, Rifamate, Rimactane, Rifadin), rifapentine (Priftin), dexlansoprazole (Dexilant), esomeprazole (Nexium, Vimovo), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole sodium (Protonix), rabeprazole (Aciphex), more than 1 dose of the steroid medicine dexamethasone or dexamethasone sodium phosphate, or the herbal supplement St. John’s wort. • Take any other medicines to treat HIV-1 infection, or the medicine adefovir (Hepsera).

starting treatment with COMPLERA. If you have had kidney problems, or take other medicines that may cause kidney problems, your healthcare provider may also check your kidneys during treatment with COMPLERA. • Depression or mood changes. Tell your healthcare provider right away if you have any of the following symptoms: feeling sad or hopeless, feeling anxious or restless, have thoughts of hurting yourself (suicide) or have tried to hurt yourself. • Changes in liver enzymes: People who have had hepatitis B or C, or who have had changes in their liver function tests in the past may have an increased risk for liver problems while taking COMPLERA. Some people without prior liver disease may also be at risk. Your healthcare provider may do tests to check your liver enzymes before and during treatment with COMPLERA. • Bone problems, including bone pain or bones getting soft or thin, which may lead to fractures. Your healthcare provider may do tests to check your bones. • Changes in body fat can happen in people taking HIV-1 medicines. • Changes in your immune system. Your immune system may get stronger and begin to fight infections. Tell your healthcare provider if you have any new symptoms after you start taking COMPLERA. The most common side effects of COMPLERA include trouble sleeping (insomnia), abnormal dreams, headache, dizziness, diarrhea, nausea, rash, tiredness, and depression. Other common side effects include vomiting, stomach pain or discomfort, skin discoloration (small spots or freckles), and pain. Tell your healthcare provider if you have any side effects that bother you or do not go away.

What should I tell my healthcare provider before taking COMPLERA?

All your health problems. Be sure to tell your healthcare provider if you have or had any kidney, mental health, bone, or liver problems, including hepatitis virus infection. • All the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. COMPLERA may affect the way other medicines work, and other medicines may affect how COMPLERA works. Keep a list of all your medicines and show it to your healthcare provider and pharmacist. Do not start any new medicines while taking COMPLERA without first talking with your healthcare provider. • If you take antacids. Take antacids at least 2 hours before or at least 4 hours after you take COMPLERA. • If you take stomach acid blockers. Take acid blockers at least 12 hours before or at least 4 hours after you take COMPLERA. Ask your healthcare provider if your acid blocker is okay to take, as some acid blockers should never be taken with COMPLERA. • If you are pregnant or plan to become pregnant. It is not known if COMPLERA can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking COMPLERA. • If you are breastfeeding (nursing) or plan to breastfeed. Do not breastfeed. HIV-1 can be passed to the baby in breast milk. Also, some medicines in COMPLERA can pass into breast milk, and it is not known if this can harm the baby. •

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

What are the other possible side effects of COMPLERA?

Serious side effects of COMPLERA may also include: • New or worse kidney problems, including kidney failure. Your healthcare provider should do blood tests to check your kidneys before

Learn more at www.COMPLERA.com

Brief Summary of full Prescribing Information COMPLERA® (kom-PLEH-rah) (emtricitabine 200 mg, rilpivirine 25 mg, tenofovir disoproxil fumarate 300 mg) tablets Brief summary of full Prescribing Information. For more information, please see the full Prescribing Information, including Patient Information. What is COMPLERA? • COMPLERA is a prescription medicine used as a complete HIV-1 treatment in one pill a day. COMPLERA is for adults who have never taken HIV-1 medicines before and who have no more than 100,000 copies/mL of virus in their blood (this is called ‘viral load’). Complera can also replace current HIV-1 medicines for some adults who have an undetectable viral load (less than 50 copies/mL) and whose healthcare provider determines that they meet certain other requirements. • COMPLERA is a complete regimen and should not be used with other HIV-1 medicines. HIV-1 is the virus that causes AIDS. When used properly, COMPLERA may reduce the amount of HIV-1 virus in your blood and increase the amount of CD4 T-cells, which may help improve your immune system. This may reduce your risk of death or getting infections that can happen when your immune system is weak. • COMPLERA does not cure HIV-1 or AIDS. You must stay on continuous HIV-1 therapy to control HIV-1 infection and decrease HIV-related illnesses. • Ask your healthcare provider about how to prevent passing HIV-1 to others. Do not share or reuse needles, injection equipment, or personal items that can have blood or body fluids on them. Do not have sex without protection. Always practice safer sex by using a latex or polyurethane condom to lower the chance of sexual contact with semen, vaginal secretions, or blood. What is the most important information I should know about COMPLERA? COMPLERA can cause serious side effects, including: • Build-up of an acid in your blood (lactic acidosis). Lactic acidosis can happen in some people who take COMPLERA or similar (nucleoside analogs) medicines. Lactic acidosis is a serious medical emergency that can lead to death. Lactic acidosis can be hard to identify early, because the symptoms could seem like symptoms of other health problems. Call your healthcare provider right away if you get any of the following symptoms which could be signs of lactic acidosis: – feel very weak or tired – have unusual (not normal) muscle pain – have trouble breathing – having stomach pain with nausea or vomiting – feel cold, especially in your arms and legs – feel dizzy or lightheaded – have a fast or irregular heartbeat • Severe liver problems. Severe liver problems can happen in people who take COMPLERA. In some cases, these liver problems can lead to death. Your liver may become large (hepatomegaly) and you may develop fat in your liver (steatosis). Call your healthcare provider right away if you get any of the following symptoms of liver problems: – your skin or the white part of your eyes turns yellow (jaundice) – dark “tea-colored” urine – light-colored bowel movements (stools) – loss of appetite for several days or longer – nausea – stomach pain

• You may be more likely to get lactic acidosis or severe liver problems if you are female, very overweight (obese), or have been taking COMPLERA for a long time. • Worsening of Hepatitis B infection. If you have hepatitis B virus (HBV) infection and take COMPLERA, your HBV may get worse (flare-up) if you stop taking COMPLERA. A “flare-up” is when your HBV infection suddenly returns in a worse way than before. COMPLERA is not approved for the treatment of HBV, so you must discuss your HBV with your healthcare provider. – Do not run out of COMPLERA. Refill your prescription or talk to your healthcare provider before your COMPLERA is all gone. – Do not stop taking COMPLERA without first talking to your healthcare provider. – If you stop taking COMPLERA, your healthcare provider will need to check your health often and do blood tests regularly to check your HBV infection. Tell your healthcare provider about any new or unusual symptoms you may have after you stop taking COMPLERA. Who should not take COMPLERA? Do not take COMPLERA if you also take any of the following medicines: • Medicines used for seizures: carbamazepine (Carbatrol, Equetro, Tegretol, Tegretol-XR, Teril, Epitol); oxcarbazepine (Trileptal); phenobarbital (Luminal); phenytoin (Dilantin, Dilantin-125, Phenytek) • Medicines used for tuberculosis: rifabutin (Mycobutin); rifampin (Rifater, Rifamate, Rimactane, Rifadin); rifapentine (Priftin) • Certain medicines used to block stomach acid called proton pump inhibitors (PPIs): dexlansoprazole (Dexilant); esomeprazole (Nexium, Vimovo); lansoprazole (Prevacid); omeprazole (Prilosec, Zegerid); pantoprazole sodium (Protonix); rabeprazole (Aciphex) • Certain steroid medicines: More than 1 dose of dexamethasone or dexamethasone sodium phosphate • Certain herbal supplements: St. John’s wort • Certain hepatitis medicines: adefovir (Hepsera), lamivudine (Epivir-HBV) Do not take COMPLERA if you also take any other HIV-1 medicines, including: • Other medicines that contain tenofovir (ATRIPLA, STRIBILD, TRUVADA, VIREAD) • Other medicines that contain emtricitabine or lamivudine (ATRIPLA, Combivir, EMTRIVA, Epivir, Epzicom, STRIBILD, Trizivir, TRUVADA) • rilpivirine (Edurant) COMPLERA is not for use in people who are less than 18 years old. What are the possible side effects of COMPLERA? COMPLERA may cause the following serious side effects: • See “What is the most important information I should know about COMPLERA?” • New or worse kidney problems, including kidney failure. Your healthcare provider should do blood and urine tests to check your kidneys before you start and while you are taking COMPLERA. If you have had kidney problems in the past or need to take another medicine that can cause kidney problems, your healthcare provider may need to do blood tests to check your kidneys during your treatment with COMPLERA. • Depression or mood changes. Tell your healthcare provider right away if you have any of the following symptoms: – feeling sad or hopeless – feeling anxious or restless – have thoughts of hurting yourself (suicide) or have tried to hurt yourself • Change in liver enzymes. People with a history of hepatitis B or C

virus infection or who have certain liver enzyme changes may have an increased risk of developing new or worsening liver problems during treatment with COMPLERA. Liver problems can also happen during treatment with COMPLERA in people without a history of liver disease. Your healthcare provider may need to do tests to check your liver enzymes before and during treatment with COMPLERA. • Bone problems can happen in some people who take COMPLERA. Bone problems include bone pain, softening or thinning (which may lead to fractures). Your healthcare provider may need to do tests to check your bones. • Changes in body fat can happen in people taking HIV-1 medicine. These changes may include increased amount of fat in the upper back and neck (“buffalo hump”), breast, and around the main part of your body (trunk). Loss of fat from the legs, arms and face may also happen. The cause and long term health effect of these conditions are not known. • Changes in your immune system (Immune Reconstitution Syndrome) can happen when you start taking HIV-1 medicines. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Tell your healthcare provider if you start having any new symptoms after starting your HIV-1 medicine. The most common side effects of COMPLERA include: • Trouble sleeping (insomnia), abnormal dreams, headache, dizziness, diarrhea, nausea, rash, tiredness, depression Additional common side effects include: • Vomiting, stomach pain or discomfort, skin discoloration (small spots or freckles), pain Tell your healthcare provider if you have any side effect that bothers you or that does not go away. • These are not all the possible side effects of COMPLERA. For more information, ask your healthcare provider. • Call your healthcare provider for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. What should I tell my healthcare provider before taking COMPLERA? Tell your healthcare provider about all your medical conditions, including: • If you have or had any kidney, mental health, bone, or liver problems, including hepatitis B or C infection. • If you are pregnant or plan to become pregnant. It is not known if COMPLERA can harm your unborn child. – There is a pregnancy registry for women who take antiviral medicines during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. Talk to your healthcare provider about how you can take part in this registry. • If you are breastfeeding (nursing) or plan to breastfeed. Do not breastfeed if you take COMPLERA. – You should not breastfeed if you have HIV-1 because of the risk of passing HIV-1 to your baby. – Two of the medicines in COMPLERA can pass to your baby in your breast milk. It is not known if this could harm your baby. – Talk to your healthcare provider about the best way to feed your baby. Tell your healthcare provider about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements: • COMPLERA may affect the way other medicines work, and other medicines may affect how COMPLERA works. • If you take certain medicines with COMPLERA, the amount of COMPLERA in your body may be too low and it may not work to help

control your HIV-1 infection. The HIV-1 virus in your body may become resistant to COMPLERA or other HIV-1 medicines that are like it. • Be sure to tell your healthcare provider if you take any of the following medicines: – Antacid medicines that contain aluminum, magnesium hydroxide, or calcium carbonate. Take antacids at least 2 hours before or at least 4 hours after you take COMPLERA. – Certain medicines to block the acid in your stomach, including cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), or ranitidine hydrochloride (Zantac). Take the acid blocker at least 12 hours before or at least 4 hours after you take COMPLERA. Some acid blocking medicines should never be taken with COMPLERA (see “Who should not take COMPLERA?” for a list of these medicines). – Medicines that can affect how your kidneys work, including acyclovir (Zovirax), cidofovir (Vistide), ganciclovir (Cytovene IV, Vitrasert), valacyclovir (Valtrex), and valganciclovir (Valcyte). – clarithromycin (Biaxin) – erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone) – fluconazole (Diflucan) – itraconazole (Sporanox) – ketoconazole (Nizoral) – methadone (Dolophine) – posaconazole (Noxafil) – telithromycin (Ketek) – voriconazole (Vfend) Know the medicines you take. Keep a list of all your medicines and show it to your healthcare provider and pharmacist when you get a new medicine. Do not start any new medicines while you are taking COMPLERA without first talking with your healthcare provider. How should I take COMPLERA? • Stay under the care of your healthcare provider during treatment with COMPLERA. • Take COMPLERA exactly as your healthcare provider tells you to take it. • Always take COMPLERA with food. Taking COMPLERA with food is important to help get the right amount of medicine in your body. A protein drink is not a substitute for food. If your healthcare provider decides to stop COMPLERA and you are switched to new medicines to treat HIV-1 that includes rilpivirine tablets, the rilpivirine tablets should be taken only with a meal. Keep COMPLERA and all medicines out of reach of children. This Brief Summary summarizes the most important information about COMPLERA. If you would like more information, talk with your healthcare provider. You can also ask your healthcare provider or pharmacist for information about COMPLERA that is written for health professionals, or call 1-800-445-3235 or go to www.COMPLERA.com. Issued: December 2013

COMPLERA, the COMPLERA Logo, EMTRIVA, GILEAD, the GILEAD Logo, GSI, HEPSERA, STRIBILD, TRUVADA, VIREAD, and VISTIDE are trademarks of Gilead Sciences, Inc., or its related companies. ATRIPLA is a trademark of Bristol-Myers Squibb & Gilead Sciences, LLC. All other marks referenced herein are the property of their respective owners. ©2014 Gilead Sciences, Inc. All rights reserved. CPAC0098 02/14

Hello Justin,

My condom broke and now I don’t know what to do. What should I do? I’m straight and I was having sex with my girl in her ass and it broke. I didn’t think I had any lube, so this time I just spit on the condom and used my saliva as lube. When I penetrated her I didn’t really feel anything went wrong. After about an hour of having sex I ejaculated. But I didn’t know the condom had broken until after I pulled out of her. I then quickly ran to the bathroom and checked more thoroughly—and yes it broke indeed. I flushed the condom before my girlfriend saw me and I don’t think she saw the condom after I pulled out of her. I’m very scared at this point. I hear that anal sex causes AIDS. Is that true? If it is, which one of us has it? —Andre Okay, Andre, do not panic. As a member of the booty love fan club myself, I must say that I commend you on having the courage to write me. Not many straight guys do write in about the booty love, aka anal sex. Let me just say this, as a gay man I can say I have experience with the booty love. Now, first things first. I believe you say in your e-mail, “I didn’t think I had any lube, so this time I just spit on the condom and used

my saliva as lube.” I’m guessing that this isn’t the first time you and your girlfriend have had anal sex, and you’ve used lube in the past. Lube has components that saliva does not, so, while saliva is very hot to use when having spontaneous sex, or even planned sex, it dries up a lot faster than lube does. In other words, using saliva means there’s a greater chance that the condom will break. Reconsider using lube when using a condom. There are tons of new lubes that are out now that anyone who lives in the United States with cable can see commercials for. They are also available at almost any drugstore. I suggest using AstroGlide or a product called Gun Oil—I know I like it. Wink! And, dude, in my opinion you should tell your girlfriend what happened. That’s my second suggestion. I know that you might be thinking that just because you can’t get her pregnant through anal sex, means it makes little difference if the condom broke or stayed intact. You’re right about that one, my friend, but, why would you try to hide the fact that the condom broke from her? It’s okay to be honest with her. If she truly loves you she will understand. I think you both should sit down and have a deep discussion about anal sex and then start exploring different types of lubrications and make

it fun for her. This way you will not think you have to hide things from her. The communication should always be open when it comes to sex with your partner(s). If you are not open about the love and sex you want from your partner(s) then you will not get the love or sex that you want. That might leave you a little high and dry…no pun intended… okay pun intended. Okay, and, finally, anal sex itself does not cause AIDS. If you or your girlfriend do not have HIV than neither one of you can get HIV from each other. HIV is transmitted only if you are exposed to someone who already is infected with HIV. My suggestion is to get tested and make sure your girlfriend gets tested as well. Also, consider picking up some pamphlets about HIV transmission from the place where you usually get tested for HIV. If you don’t have a place to get tested, you need to find one by going to A&U (www.aumag.org) and clicking on the Testing & Care Locator link or some place similar on the Internet to search for it. It’s best to know if you are HIV-positive or negative than to go on with life not knowing at all. So, next time, remember: Lube it up before you beat it up! For more information log on to the Centers for Disease Control and Prevention (CDC) Web site: www.cdc.gov/sexualhealth. ◊

A&U • APRIL 2014

Justin B. Terry-Smith has been fighting the good fight since 1999. He’s garnered recognition and awards for his work, but he’s more concerned about looking for new ways to transform society for the better than resting on his laurels. He started up in gay rights and HIV activism in 2005, published an HIV-themed children’s book, I Have A Secret (Creative House Press) in 2011, and created his own award-winning video blog called, “Justin’s HIV Journal”: justinshivjournal.blogspot.com. Now, with this column, Justin has found a way to give voice to the issues that people write to him about. Visit his main Web site at www.justinbsmith.com. He welcomes your questions at jsmithco98@hotmail.com.

“AN UNFLINCHING MASTERPIECE.” —DAVID LEVERING LEWIS, Pulitzer Prize–winning biographer of W.E.B. Du Bois

“Daringly imagined and beautifully written, Hold Tight Gently is a major work of

modern history that chills us to the bone even as it moves us to tears.” —MICHAEL BRONSKI, Professor of Women, Gender, and Sexuality Studies, Harvard University

“A

deeply moving work of largely hidden history.”

—BARBARA SMITH, author of The Truth That Never Hurts

“A powerful book that displays both the malice and the nobility of our species.” —Kirkus Reviews “This marvelous book will be read by activists everwhere—and empower the future.” —BLANCHE WIESEN COOK, author of Eleanor Roosevelt

“Funny and moving, enlightening and thoughtful, inspiring and enraging, this dual biography reveals the heartbreaking losses caused by the epidemic as well as the many ways people fought back.” —JOHN D’EMILIO, Professor of Gender and Women’s Studies and History, University of Illinois at Chicago

THE NEW PRESS

THE NEW PRESS Publishing in the Public Interest www.thenewpress.com

lifeguide

Dropping the Ball

is it time to forge new connections & strengthen our aids communities?

’m angry. So as I write this, I cannot promise it will be a joy to read or digest. For that, I will apologize now. But I hope you’ll indulge me for a few minutes anyway. I’m angry with myself. I’m getting over yet another “reaction” to something that I woke up to one morning; my entire body—neck to toes—covered and inflamed with painful, raised, purple dots, welts, and what looked like scratches from the claws of a big cat I had managed to escape. SHINGLES?! That was my first guess. But I looked on-line for images and mine didn’t look the same. I felt better about that, but it still didn’t explain anything. Actually, it looked as if I had been trapped in a phone booth, completely nude, with a couple of large wasp nests tossed in and opened up for, say, a couple hours! Clothing, bedding, upholstery, even an attempt at a cool spray in the shower was torture. And this wasn’t like the petechiae I had written about in a previous column. Naturally, this meant another mad dash to find out what was going on. My doctor wanted blood first (the phlebotomist had trouble actually finding anywhere to poke me since the veins in my arms looked as if I had been on a year-long heroin bender). But she finally found a spot and got her pint out of me. Jump ahead. Brand new problem for me: palpable purpura, which has a wide selection of causes, but looks hideous (like big, dark lesions mixed with purple spots and raised blister-like marks— pretty). I just couldn’t wait to go out in public! Even my doctor, who has seen damn near everything, was just shocked at how badly and quickly my ailment had progressed. I got a steroid shot of Kenalog—a thick, white cream-like concoction that felt wonderful flowing through what looked like a knitting needle into my non-existent ass. It’s taken several days to even notice a fading of

the patches, lesions, spots, and blisters. But the condition is finally clearing up. So why am I angry, you may ask? I read a brief profile of Sean Strub’s new book, Body Counts: A Memoir of Politics, Sex, AIDS, and Survival, in OUT magazine last month (Mr. Strub was also profiled in the recent documentary, How to Survive a Plague.) A&U reviewed it last month, and I, personally, can’t

wait to get my hands on a copy. Strub suggests “activism has been kind of romanticized,” and that HIV-related stigma, like new infections among gay men, is getting worse. After three decades of surviving, he bemoans the loss of a communal support system: “When someone tested positive 15 or 20 years ago, there was a loving LGBT community that took on this epidemic as a shared responsibility, that put their arms around you and said, ‘We will get through this together.’” Now, that sense of care and a unity around the cause have disappeared, with negative effects: “Young people often don’t know anybody—or don’t think they know anybody—with HIV, and the LGBT movement has largely left AIDS behind.… There’s a real sense of not wanting people to forget and yet being surround-

ed, particularly in gay culture, by a world that has forgotten. There is a kind of compulsion to tell that story, and as time passes there are fewer and fewer around who can speak first hand.” Arrow aimed, fired, and a direct hit into my chest! I’m angry with myself for continuing to isolate myself and not connect as I once did with infected peers. I left my doctor’s office that day actually eyeing about six other men, my age (I’m fifty-two), looking exactly like me: frustrated, diseased, outcast, and alone. What kept me, while waiting for more bloodwork to be ordered, along with my walking papers that day, from at least saying “Hello,” or making some contact as fellow-fighters, all of whom also swam in their comfy sweats, bodies deteriorating, skin as bad— or worse—than mine? I couldn’t take just a moment to sit next to one or two of them out of common decency to reach out? An “ever feel like a phone call, or cup of coffee somewhere?” kind of thing? I’m not suggesting that saying “hi” or acknowledging other AIDS patients my age will “fix some disconnect” I experience of my own. But would it have killed me to introduce myself in a city that—in my nearly fifteen years of experience living in Las Vegas—lacks a cohesive HIV/ AIDS community? Why not begin one? Maybe it would do wonders for me. I’m not out to save the world, but it does take a village…doesn’t it? I left for my next appointment, a little teary-eyed and alone. I used to be stronger and more adaptable; more willing to put myself out there. Instead, I came home, had a good cry, and went to bed with my beloved dog, Buddy, next to me. I felt awful. Along with being a contributing writer for A&U, Chuck’s had other work published in journals, magazines, anthologies, and e-books. A&U • APRIL 2014

poetry

Logic as the Second Person Singular AIDS sufferers in Papua New Guinea have been buried alive by their terrified relatives….If they killed the victims with a machete it would expose them to infection, they believe. —The Telegraph, August 28, 2007

The birds are gone, it’s all dead now so you can stop taking pictures of your shadow. The sugarcane is lamplit and the sugar bowl is a game you play with a bit of string tied at the ends where you put your hand in and then

the string disappears. It is the color green or the Dutchman caught on the way from New Guinea with a dozen hummingbirds sewn into his underwear. Their wings were taped and placed in little coats.

A rare kind of death they found, buried alive with wings. Stabbing at the warm parts. He was caught in line for his next flight, fidgeting. You were there, stabbing ice with a straw. Customs officials snapped photographs holding the bird-filled underwear and smiling.

You don’t need sun to take pictures of shadows. You just need a camera. It’s all dead now. The lamp is glazed with sap like a tree left to itself. The sap changes the light so you can put your hand inside. It’s all dead now and the sugar bowl is stuck to the desk. Buried in a little coat, it’s all dead now, straw-haired and fidgeting. You spell colors into your thumbs and forefingers, opening and closing a paper fortune-teller. —Michael Hurley Michael Hurley’s work has appeared in the Sycamore Review, Weave Magazine, The Fourth River, Fourteen Hills, and elsewhere. He is the winner of the 2012 Keystone Chapbook Prize, and his chapbook, Wooden Boys, is forthcoming from Seven Kitchens Press. He lives in Pittsburgh.

APRIL 2014 • A&U

Get

engaged! A National Coalition Advancing Health & Healthcare Access for HIV Positive Communities

Join

Amplify the voice of PLWH in DC and around the country by joining the Pozitively Health Coalition at www.HealthHIV.org.

Engage Help us understand the needs of PLWH by taking the Pozitively Healthy survey at www.HealthHIV.org.

Connect E-mail or call Pozitively Healthy Staff: Joseph Jefferson: Joseph@HealthHIV.org Julio Fonseca: Julio@HealthHIV.org 202-232-6749 Facebook.com/PozitivelyHealthy @HealthHIV YouTube.com/HealthHIV

is a project of

A National Coalition Advancing Health & Healthcare Access for HIV Positive Communities A National Coalition Advancing Health & Healthcare Access for HIV Positive Communities

Announcing

A new national coalition for people living with HIV and their allies advocating for HIV positive communities

A National Coalition Advancing Health & Healthcare Access for HIV Positive Communities Are you concerned how health care reform will affect you?

Do you want to empower PLWH to make pozitively healthy decisions?

Join

Would you like to become a better informed consumer?

today! A National Coalition Advancing Health & Healthcare Access for HIV Positive Communities

A National Coalition Advancing Health & Healthcare Access for HIV Positive Communities

EMPOWERMENT through EDUCATION and ADVOCACY Empowered consumers are healthier consumers. Empowered consumers engage in a dialogue with their providers about their health goals and treatment plans. Consumer education helps PLWH recognize high quality, stigma-free health care and empowers them to take full advantage of health care reform. Educated consumers can effectively advocate for equitable treatment throughout the health care system. Effective advocacy by educated and empowered consumers helps ensure that competent, affordable, and effective health services and treatment are more accessible.

‘‘

Pozitively Empowering I am a 53-year-old Black gay man who has been HIV-positive for the past 25 years. I am dedicated to working with and advocating for youth, so that they may not have to endure the pain and hardships I have experienced. My involvement with Pozitively Healthy allows me to work with a diverse group of individuals on a personal, meaningful, and shared cause. I treasure the opportunity to be a positive influence and to help empower all HIV consumers. My passion for helping others has led me to join a number of advocacy groups, as well as found Brothers Reaching Others, Inc. (BRO), which provides resources, educates clients, empowers individuals, develops skills, engages others, and disseminates information to disenfranchised and impoverished communities.

ʼʼ

Edward Jackson, CEO, Brothers Reaching Others, Anniston, Alabama

Pozitively Healthy National Steering Committee

Brandon Aversano George Washington University Washington, DC

David Brakebill Florida Keys HIV Community Planning Key West, FL

Matthew Lesieur VillageCare New York, NY

Stephen Bailous Metropolitan Washington Regional Ryan White Planning Council Washington, DC

Robert Caldwell The Tauri Group, Biowatch Systems Program Office Washington, DC

Andrew Hartman Lt. Joseph P. Kennedy Institute of Catholic Charities Washington, DC

Judi Billings Targetted Alliances Puyallup, WA

Andrew Espinosa Midwest AIDS Training + Education Center Chicago, IL

Angel Hernandez Orocovis, PR

Mark Fischer Values in Action Washington, DC

Edward Jackson Brothers Reaching Others, Inc. Anniston, AL

leads to ACCESS to better care and improved health.

‘‘

Pozitively Educating and Advocating My involvement with Pozitively Healthy is rooted in understanding the history of the HIV movement, and my desire to diminish the emotional and social suffering PLWH experience due to ignorance and judgment. I see stigma as one of the largest barriers to testing and treatment. We need to change the way HIV is understood in public discourse; HIV is a virus and a public health issue. My long-term vision for Pozitively Healthy is to one day look back at the victory over stigma and judgment and see an enlightened and accepting society that recognizes HIV as a medical issue as opposed to a moral one.

ʼʼ

Ann Stuart Thacker, Executive Director, AIDSNET, Bethlehem, PA

‘‘

Pozitively Improving Access to Better Health As a gay man born during the height of the HIV/AIDS crisis, I never would have guessed that nearly 30 years later that stigma, barriers to quality heath care, and undue suffering would still exist for so many members of my community. Heroic efforts and huge advancements in science have been made; however, we have seen little progress in addressing not only the stigma of being HIV-positive, but also the legal and emotional ramifications of intolerance and misinformation. It is because of this uphill battle for PLWH that I have chosen to advocate on behalf of myself, my friends, and my community by joining Pozitively Healthy. It is because of those men and women who fought during the early days that I’m able to now lend my voice in support for those will come after me. Bryce Romero, Consumer Marketing Assistant, Human Rights Campaign

ʼʼ

Pozitively Healthy advocates and educates so that the HIV community is and remains Pozitively Healthy

Angel Lozada Pittsburgh, PA Randal Lucero National Quality Center, Consumer Advisory Committee New Mexico Aging & Long-Term Services Department’s HIV/AIDS Advocacy Network Albuquerque, NM Oliver Martin, III National United Church of Christ HIV and AIDS Network Green Bay, WI

Eric Martinez Positive Mind & Body Support Group Net Vero Beach, FL Butch McKay Okaloosa AIDS Support and Informational Services, Inc. (OASIS), Fort Walton Beach, Florida Mark Peterson Michigan Positive Action Coalition (MI-POZ) Detroit, MI

Bryce Romero Human Rights Campaign Washington, DC

Ann Stuart Thacker AIDSNET Bethlehem, PA

David Sheon Whitecoat Strategies, LLC Washington, DC

Tim Vincent California STD/HIV Prevention Training Center Oakland, CA

John Tenorio Pueblo Community Health Center EIS Program Canton City, CO

David Waggoner A&U, America’s AIDS Magazine Albany, NY Channing Wayne Larkin Street Youth Services San Francisco, CA

THE THINGS he things we leave behind are, in rare cases, works of art or professional accomplishments that live on. In some cases we leave behind our DNA to live on through generations. In some cases what we leave behind are memories in the minds of loved ones. But the common denominator, and sometimes the only thing many people leave behind, are objects. It’s those objects left behind that inspired Dudley Saunders, a Los Angeles-based singer, songwriter and artist to

With “In These Boxes,” performance

create his latest multimedia performance piece, “In artist Dudley Saunders uses objects These Boxes.” He begins to bring back lives cut short speaking to the audience and recalling a memory from the depths of the by Larry Buhl plague days. It was the early 1980s, he was living in Manhattan’s East Village and found boxes everyarrange them correctly to bring that person where, filled with personal to life if for a moment. belongings, left unceremoniously and Saunders describes “In These Boxes” hastily on the sidewalk. He soon learned as a “social media cemetery.” Using twelve that they were the boxes that contain the detritus of twelve personal affects of lives, Saunders tells their hidden stories those who had died and symbolically brings them back to life. of AIDS-related With acoustic guitar and minimal accomcomplications. “You could tell it paniment—an accordion or keyboard— Dudley performs songs and stories based was an AIDS death on these boxes, stories that are at once because there was minimalist and highly evocative. It’s not a no family to collect unique way of creating art. Visual artists the things, which like sculptor Joseph Cornell are famous was common for for creating boxed arrangements of objects the rejected gay that once belonged to someone no longer men then,” says alive. But the sparse, minimalist, and Saunders, who is heartfelt (and beautiful) songs and stunalso gay. ning imagery projected behind Saunders Some of these make the piece his own. items were quite Only one story is literally true, but all of personal—letters, a these stories, Saunders says, are real. collection of thirty “We can’t all be heroes,” Saunders years of Playbills, says, introducing one song. The baredrawings—and bones stories he weaves through song are most of them were about those who lived (mostly) un-heromundane. “But ically, their quotidian lives snuffed out, to me they were sometimes with a bang, sometimes with a the only evidence whimper. One is about a Russian who moves that someone had to the U.S., beaten down by prison life in lived—and there his country only to waste his final days in they sat, in boxes stocking feet in a wheelchair in the parking lot in the garbage, of a West Hollywood 7-11. Another is about a about to disappear.” young man from a small town who comes to Saunders says it’s New York for adventure, and men, and gets possible to save more than he bargained for. certain details of a person’s life and During one song, “The Man in the A&U • APRIL 2014

photos by Dean Carpentier

we left BEHIND

A&U Gallery

Thinking inside the box: Dudley Saunders performs his multimedia piece, “In These Boxes,” at its February 8th premiere.

Game,” the box projected on the screen contains a gun. The song tells the story of a teen boy obsessed with the man in his video game—and in the video art piece, the boy picks up this real gun in front of his video-game screen and handles it, learns to aim it and fire it, then takes it into the real world, where he tries to find the man in the game in a real-world situation. “The stories are unsatisfying in a sense that most people don’t have a heroic life following the ‘Hero’s Journey,’” Saunders tells A&U. Only half of “In These Boxes” explores AIDS or gay issues, and even less of the piece is strictly personal. What ties all of these stories together is lives interrupted and, except for the objects left behind, largely forgotten, Saunders says. A song about ACT UP, which Saunders was active in, really is about heroes who put their lives on the line. Saunders makes it clear that he has immense admiration for fellow ACT UP members and others on the front lines of the HIV/AIDS crisis. “It was the people in ACT UP who show that broken people can change the world. Instead of getting

mowed down like many people and being destroyed by AIDS-phobia and homophobia, they turned around that onslaught and took on the world on their own terms.” It’s for that reason the ACT UP song gives a performance piece about death, loss and APRIL 2014 • A&U

forgetting a surprising, uplifting twist. “I never talk about AIDS in the past tense,” said Saunders, who has been positive for decades. “But during the plague years it was, death, death, death. Now, although homophobia and fear of AIDS still exists, gay people are a target market, welcomed for what we can buy.” But AIDS is still with us, Saunders adds, especially for those who fought on the front lines in the earliest days of the crisis. AIDS is still salient and personal for Saunders and the loss and grief are fuel for “In These Boxes.” In the fall of 1991 two of his former lovers died within two months of each other. It was then he realized nobody who remembered them together was still alive and their relationships had suddenly become extinct. Enter objects. The few objects Saunders had from these exes gained power and resonance after they had passed and that objects—in boxes, in drawers,

wherever—can conjure loved ones back to life for an instant. Though the objects used for “In TheseBoxes” are not personal to Saunders, they’re meaningful for the characters he’s created. In most of the videos for “In These Boxes,” Saunders projects himself into the role of these people he writes about, and literally projects himself in these roles on a screen behind him. “It isn’t a performance created to make people comfortable,” Saunders says. He tells A&U that he wanted “In These Boxes” to be about a common, private experience—owning objects—and share that experience, make it universal and “bring it out of the dark.” The social media part of the “social media cemetery” lives on-line at InTheseBoxes.com. People can become part of a living art piece by submitting photos to Instagram with the hashtag #InTheseBoxes or send them to Saunders at Dudley@ dudleysaunders.com. Saunders will be performing “In These Boxes” around the U.S. throughout 2014, with various dates still to be added. At its Los Angeles debut at the Eagle Rock Center for the Arts, several audience members approached Saunders after the show, eager to learn more about the people he wrote and sang about. One suggested that he expand on them to build a series of short stories. Clearly Saunders has mastered the performing arts mandate of entertaining the audience but leaving them wanting more. Larry Buhl writes A&U’s monthly Hep Talk column.

full plate

Ted Allen, Host of Chopped, Explains Why We Should Dine Out for Life by Alina Oswald

Illinois; Washington, D.C.; and Victoria, British Columbia, and more than 3,000 participating restaurants, raising in the vicinity of $3–4 million in funds. For the eight years, the fundraiser has been sponsored by Subaru of America, and attracted celebrities who became spokespeople for the event. Celebrities like Mondo Guerra [A&U, January 2013],

winner of Project Runway All-Stars; SAG Award nominee actress Pam Grier [A&U, April 2013]; Daisy Martinez of the Food Network’s ¡Viva Daisy!; and Ted Allen, host of Food Network’s award-winning show Chopped. On January 28, Allen graciously spent the day making phone calls and conducting interviews to help spread the A&U • APRIL 2014

photo by Peter Ross

hat’s for dinner?” The ever-recurring and often tedious question we ask ourselves (or are being asked) almost every single day may finally get a favorable answer, at least for one day. Imagine this: It’s Thursday night, a weeknight, and you don’t have to prepare dinner. Instead, you go out to eat, and maybe even bring your friends and family along. And you feel good about it, because you go Dining Out for Life. On Thursday, April 24, you and your loved ones can do just that. You can dine out for a good cause—that is raise money to fight HIV and AIDS, as part of the Dining Out for Life fundraising event. Dining Out for Life started in 1991, thanks to a volunteer at ActionAIDS Philadelphia. The idea behind it is quite simple: “Dine Out, Fight AIDS.” All you have to do to support the cause is go out on the last Thursday of April, and eat at one of the Dining Out for Life participating restaurants. In turn, the restaurants donate part of the day’s proceeds to DOFL participating AIDS service organizations. While the fundraiser takes place each year on the last Thursday of April, some participating restaurants pick their own dates, sometimes outside the month of April. In a quote about the choice of the official date for this event, Michael Byrne, Treasurer of the Dining Out for Life Board of Directors and Director of Development of ActionAIDS, states: “Many moons ago, we searched for a national date, and that was what came out of that meeting. It was discussed, debated, and deliberated for years before we finally found a date. I know it certainly saved agencies Snow Insurance coverage, which is not cheap!” Byrne adds, “The first year brought in about $20,000. We came a long way since then!” Dining Out for Life is now reaching cities across the U.S. and Canada, including Albany, New York; Asheville, North Carolina; Ft. Lauderdale, Florida; Chicago,

word about his six-year involvement with the fundraiser, and this year’s Dining Out for Life event. Besides hosting Chopped, Ted Allen is the author of several books, including his latest In My Kitchen: 100 Recipes and Discoveries for Passionate Cooks (Clarkson-Potter), a contributor to publications like Esquire, Bon Appétit, Epicurious, and Food Network magazine, a judge on Bravo’s Top Chef and Food Network’s Iron Chef America, and food and wine specialist on the Bravo series Queer Eye for the Straight Guy. Yes, that Ted Allen called me to talk about something he’s passionate about—encouraging people to go Dining Out for Life, and also to get tested for HIV and know their status. I have to say that the experience of chatting with none other than Ted Allen was extraordinary. The conversation—informal, honest, and unscripted. Alina Oswald: In a Food Network interview you mentioned that you’d like to cook for President Obama. I was wondering what would you prepare for the President? Ted Allen: I have a friend who cooks in the White House on the staff. He told me that the president and his family like pretty simple food—like a roasted chicken. [The President] likes burgers. He knows fine cooking, of course, goes to fine restaurants, but at home, I think they like very traditional American cooking. My thought has always been...I’m not a professional chef, so if I’m going to cook for somebody important, I’m not going to do something fluffy [or] fancy. [I’ll] try to do something straightforward, delicious, and flavorful. So, I think I might APRIL 2014 • A&U

probably do a porchetta, which is roasted pork with a bunch of herbs, olive oil, and garlic. It’s simply delicious, and satisfying, something that I definitely know how to cook. I don’t want to burn the food. [He laughs.] So far, he’s never asked, but if he ever asked, I would definitely cook for the President. Tonight the President will deliver the State of the Union Address. What would you like to hear him say regarding HIV/AIDS? I’d love to see him pass the ENDA [Employment Non-Discrimination Act] so that people cannot be fired for being LGBT, as they can in so much of our country. But we shall see. In terms of HIV and AIDS, I think he’s done a pretty fine job, and, in fact, that was something that even President Bush [W.] was actually dead-on about, certainly in developing countries. But, you know, HIV/ AIDS remains a serious problem here, [in the States]. It’s not necessarily the immediate death sentence that it was in 1987, but still....New infections are up among young men. Women of color are powerfully affected by HIV and AIDS. It still costs millions upon millions [of dollars] in our country. So, this is still a fundraising effort that is definitely needed. You’ve been an active spokesperson for Dining Out for Life for six years now. Every year, in just one night, the event helps raise money for the AIDS cause, engaging individuals and businesses. What’s the forecast for this year’s fundraising efforts? [It’s interesting] because the first year [Dining Out for Life] was only in Philly, and now it’s in at least sixty cities all over the country [and Canada], [in] more than 3,000 restaurants, a year ago. [For this year] I do know that they are hoping to reach the goal of $4 million. By the way, all that money stays in your own community. New York City, in my neck of the woods, is not participating in the Dining Out for Life event. New York City has not been a part of this fundraiser, because, being sort of Ground Zero for the AIDS epidemic, New York has so many HIV and AIDS service organizations. It was decided that this city didn’t need another one. There’re so many organizations doing the work here (like God’s Love We Deliver), not to mention the government and state organizations, that the need is so much higher in Youngstown, Ohio, or even Chicago, Illinois. But New York City, I think they got it covered.

What would you encourage people to do relative to AIDS awareness and/or fundraising, beyond dining out on April 24? One thing that’s coming to life these days is the renewed importance of being tested. If a person is sexually active, and is not monogamous, it’s more important than ever to know whether [that person is] infected. So, something to think about is: if you are, [or] if it’s possible that you could have been exposed [to HIV], if you had sex that was not safe, you should get tested; for a large variety of reasons, not the least which is the treatments. [Because] it’s not just about your own health. It’s about that, too, but the treatments, today, not only do they keep [you] the infected person healthy; they also dramatically reduce how infectious you are. So that other people that you have contact with are less likely to get infected, themselves. I would think testing and awareness [are important.] Preventive medicine [is always better] than reactive medicine. Don’t you think? Today we cannot really talk about HIV/ AIDS education and prevention without addressing the topic of youth and AIDS. It’s the same kind of message that Magic Johnson is trying to get out regardcontinued on page 60

Crazy Like a Fox Actress Traci Dinwiddie May Poke Fun at Herself But When It Comes to Serious Fundraising She’s a Peach by Dann Dulin

Creek, One Tree Hill, 90210, and Make It or Break It. But Traci’s most challenging role may have been a cyclist for AIDS/LifeCycle (ALC) last summer. She raised over $107,000. That’s worth a repeat. She raised over $107,000! At the finish line many greeted her, including fans and friends, some from as far away as Australia. Traci’s also an active supporter of human and animal rights, and suicide prevention. In between acting roles, she teaches yoga, trains on trapeze, writes for magazines, and drums West African rhythms. Traci also created #MoustacheMonday videos, where she sports a fake moustache in blog-style entries, sometimes dancing her ass off to assorted high-en-

ergy tunes. Dinwiddie (her adopted father’s name) is of Scottish origin and the Alaskan-born, North Carolina-bred gal also claims Arab, German and Cherokee Indian as part of her heritage. The self-proclaimed, “part time badass and full-time fruitcake” had such an enlightening adventure with ALC that she’s gearing up to ride again in June. (You can contribute at: www.tofighthiv.org/goto/tracidinwiddie.) Traci affectionately calls her cyber friends who have wholly supported her throughout her ALC odyssey, “T-bugs.” Dann Dulin: What’s your inspiration for those wonderful wacky videos, “Moustache Monday?” Traci Dinwiddie: I used to get what my mom would call “the Sunday night blues.” Moustache Mondays are my way of making light-hearted play for a day that tends to bring so much anxiety. It’s just silly fun. Yes, fascinating enough, Sunday nights always seem like a downer. When did you first hear about the epidemic? I remember being in middle school and bullies made fun of it. “AIDS” was a scary word and often used as an insult. When I think of HIV/AIDS now, I think of friends, hope, and healing. That’s a lovely thought, Traci. How has the epidemic affected you? Honestly, I don’t know anyone who hasn’t been affected in some way. I’ve lost many dear friends and I have many friends who are HIV-positive. It is simply a part of my life.

A&U • APRIL 2014

cycling photo courtesy Traci Dinwiddie; portrait by Traver Rains

er eyes are ablaze with jet engine white-hot flames while blood tears rapidly stream down her pained face. This could be the one intense moment that Traci Dinwiddie fans will remember about her career, thus far, portraying the blind psychic Pamela Barnes on TV’s sci-fi series, Supernatural. Traci has had other profound scenes as an actor, as well, like her award-winning performance in the film, Elena Undone. Her voice also gave life to the animated character, Tanzi the lady Ninja, in the Web series, Zombies vs Ninjas. A versatile actress, she even played the legendary Country/Western singer, Patsy Cline, in the stage production of Always, Patsy Cline. Other television credits include Dawson’s

What motivated you to ride in the AIDS/LifeCycle? I had known about it for a few years, but it seemed like all things pointed me toward taking it on for 2013. It’s a rather big commitment to make, and the timing seemed just right to begin my ALC journey. It was in support of the wonderful friends that I lost, for the many friends living APRIL 2014 • A&U

beautiful, healthy lives thanks to The L.A. Gay & Lesbian Center’s services, and for my sober sisters and brothers. My partner, Kristin, is the associate director at the AIDS/LifeCycle L.A. office, and I wanted to stand beside her with my complete support. It thrilled me to be able to use my teensy bit of celebrity to bring awareness to this often-forgotten issue. We don’t see AIDS in

the news anymore, and there is still a stigma to deconstruct. I like a meaningful project as well as a damn good challenge. So, it was a perfect fit. It’s people like you who, thankfully, blast ignorance! How long have you been sober? Well, thank you. Fourteen. continued on page 62

RollingHard Heart Role into a

Tim Cummings Talks with Brutal Honesty About His Journey in Portraying an Early AIDS Activist Icon by Dann Dulin

Dann Dulin: What was your experience portraying Ned Weeks? Tim Cummings: “Jigsawian” is the first word that comes to mind. It’s not really a word, but it fits. Some nights the pieces of

the puzzle all came together and I felt fulfilled. Other nights, the pieces were scattered everywhere and I felt overwhelmed. But, I hope every actor out there with some chops gets a crack at a role like this. There are profound physical, emotional, and psychological challenges in inhabiting him. Every morsel of training I’d ever received as an actor, and as a human, was utilized in his creation and my portrayal of him. That’s a good feeling, you know? I learned so much and had such a blast. How did you prep for this character? Research. I’m very much a scientist when it comes to being an artist. I was steeped in the world of the play: the early eighties in New York City at the beginning of the epidemic. I studied an abundance of books, films, plays, movies, articles, and did meditation. And, I really studied Larry Kramer. I wanted to understand. I wanted to know who I was becoming, intrinsically. It was an interpretation, I would later discover, that was met, critically, with celebration and fanfare, primarily, but also with much disdain and recrimination. Not surprisingly, when you really look at the role for what it is, it’s a curate’s egg—you’re trying to play a real person who was infamously difficult: loud, lonely, angry, brash in his Jewishness, unwilling to relent. It says these things in some form or another on nearly every page of the script, mind you, and it’s a huge script. It certainly is and I believe you’re in practically every scene…. At the same time, Ned is the hero of the story; you have to like him enough to go on the journey with him: from the activist A&U • APRIL 2014

photo by Erin Noble

pon receiving an invitation for this interview, Tim Cummings asked if he would be naked on the cover and, if so, to give him a couple of months to lose 130 pounds. We replied that a lot of us have already seen him naked. Well, metaphorically speaking, that is. Late last year, Tim gave a raw stellar performance as Ned Weeks in The Normal Heart at L.A.’s Fountain Theatre, a cutting edge award-winning venue. The now legendary play, which will be brought to the screen by HBO and Glee creator, Ryan Murphy, is set during the early days of the epidemic. Penned by the irascible AIDS activist Larry Kramer, the character Ned Weeks is, in fact, his alter ego. The show originally premiered at New York’s Public Theater in 1985. In 2011, The Normal Heart made its Broadway debut, earning a Tony Award for Best Revival of a Play and for actors John Benjamin Hickey and Ellen Barkin. Tim performed fifty sold-out performances, receiving standing ovations every night. Thus far, he’s won the Broadway World Award for Best Lead Actor. The Los Angeles Drama Critics Circle (LADCC) honored the production with four nominations, including Best Production (Revival) and Tim, as Best Leading Actor. Raised on the North Shore of Long Island, Tim began his career on the New York stage. He served as Stanley Tucci’s understudy in the Broadway production of Frankie and Johnny in the Clair de Lune. (Not an easy task being an understudy, yet a master class for the actor. “It was a magical and fulfilling experience,” recalls Tim.) For over a decade Cummings has worked with such talent as Edie Falco, Joe Mantello, Susan Sarandon, and Sigourney Weaver. His film and television credits include Criminal Minds, The Guys, Presence, and My Two Fans. He’s also collaborated with Big Dance Theatre and The Builders Association, and he serves as Co-Literary Manager for EST/LA and Associate Director of the Youth Program at the Ojai Playwrights Conference. Tim and his partner, Paul, a former actor and currently a Psychotherapist (“He looks like Paul Newman”), have donated and volunteered over the years to HIV/AIDS organizations. During the run of The Normal Heart, many HIV/AIDS organizations attended the show and afterwards talkbacks were conducted. (“There were some amazing people who participated and I have it in mind to contact them and get more involved.”) Living near the Los Angeles County Museum of Art, the brawny six-foot-two Irish-Italian’s hobbies are astronomy, marine biology, and arachnology. Spiders?!

photos by Ed Krieger

he has to become, to the love that he finds and embraces, the political and medical maelstrom he endures, and the crushing loss that he suffers. It’s a universal story. It’s the hero’s journey through-and-through. I did get in touch with Joe Mantello [who played Ned in the Broadway revival]. Joe is a friend, a brilliant artist, someone I’ve worked with in the past, and he was instrumental in offering me support, advice, anecdotes, and humor as I went through it all. C’mon! Ned is a banshee. You know? He has to yell and scream. A banshee warns of impending doom. That is what Ned was doing. That’s the point of the play. Danger. Unease. Love. You just gave this reporter chills, Tim. It’s such a powerful, Playing Ned: Tim Cummings as The Normal Heart’s Ned Weeks gets expressive with demanding role…. Stephen O’Mahoney as Bruce (top) and cradles Billy Brochtrup as Felix (bottom). It was quantum leaping. It was channeling. It was a service job. And been any aftereffect? experimenting sexually had to be aggresfrom the stress, I smoked a cigarette Yeah, I feel like I’m experiencing sively cautious, because although they for the first time in six goddam years. aftershock. My head feels a little haunted. seemed to have the epidemic under some Sometimes I miss it all so much I feel kind of control—whatever that implies in Did you do anything in particular right like I should never act again, lest I wipe the context of this epidemic’s history— before your first entrance? it clean from my mind and the memory you did not want to contract HIV. It was a I danced. Every time. From our vanishes. I miss the cast—a lot. When death sentence. fifteen-minute call to “Places,” I was I said goodbye to Bill [Brochtrup, who My generation of gay men seems to backstage dancing like a freak. played Felix, Ned’s partner] on the last have come up in more of a sexual represday, I felt like we were breaking up. I sion than any kind of sexual revolution. I It’s been a couple of months since you mean, it felt as if we’d been in a relationrefer to us as “Generation II” or “Intimawere involved with the play, has there ship for months. I fell in love and lost cy Issues.” I’ll never forget one guy who him fifty times. wrote and performed a song for our muOther times I am so relieved I sic class called “Masturbation: The Sex of don’t have to do it anymore. On good Our Times.” He was right. It was a good days, I’m so proud of my dedication song. I ended up giving him a handjob and commitment to the whole thing out of admiration—and, cos I thought it that I feel like I gave birth to a future was appropriate. sovereign. Look, doing low-pay theatre in L.A. is not easy. It’s definitely someHave you met Larry Kramer? thing you do for the love of the art. I’d like to. There were many people, Primarily a theatre actor, as I am, L.A. however, who saw our production who is not, ultimately, the town I ought to came up to me afterward to tell me that be in. But, I’m working on that…. they knew Larry well. They had been there with him during the dark times and I hope so. I want to see what you tackle that he would be extremely proud of my next. Did you ever see The Normal depiction. “God, you were so annoying,” Heart performed? they’d say. “Quirky, lovable, voluble— I did not. I saw scenes from it while that’s what he was like!” That made me a student at NYU. During that time, in feel good, you know? the early nineties in New York, Silence = Death [ACT UP’s rallying cry] was What a nice tribute. So you’ve completed plastered everywhere. Young guys who Ned Weeks! What character are you dying were coming out of the closet and/or continued on page 62 APRIL 2014 • A&U

G N I P P A G N R I WWRAPP P P UU As He Preps for a Big Move, Actor &

Chef David Burtka Takes Time to Share with A&U’s Dann Dulin His Sage Advice about HIV Prevention and Giving Back to Our Communities

photographed exclusively for A&U by Annie Tritt

fter knocking on the front door of David Burtka’s Sherman Oaks residence in the hills above the San Fernando Valley, he gently cracks open the front door halfway and in a hushed tone, says, “The kids are sleeping.” David and his fiancé, Neil Patrick Harris, bore fraternal twins by an anonymous egg donor and a surrogate mother in 2010. Both supplied their own DNA. They named their daughter, Harper, and their son, Gideon, and they call David “Dad.” Neil is known as “Papa.” David also has twins with former partner, actor Lane Janger, and he continues to play a supportive role in raising them. (“The relationship may not have worked out, but you don’t divorce kids.”) Having just returned from a meeting at CBS, David is debonair in slick dark suit pants, white starched shirt with rolledup sleeves, and a loosened dark maroon, dark blue striped tie. He asks if I mind conducting the interview in the backyard on this breezy overcast early afternoon. He escorts me down the slick-polished dark cherry wood floor hallway through the mammoth gastronome kitchen where the attention-grabber is a grand flower arrangement of white-purple orchids on the counter. Female help are wandering about, one cooking at the stove, and the other picking up toys that are scattered about the floor. We walk through a small open area adjacent to the kitchen and proceed through French doors that lead to the outside. Purchased in 2006, their two-story Cape Cod-ish style home is now on the market as they prepare to move to Manhattan. Neil’s show, How I Met Your Mother, came to an end in February after nine seasons and he immediately flew to New

York to start rehearsals for Broadway’s Hedwig and the Angry Inch. David will follow in late April after the completion of renovations on their new digs in Harlem. “The kids are giving up all this for city living. It will be an adjustment,” he acknowledges thoughtfully, as he sweeps his hands before a spacious backyard that sports a swimming pool, Jacuzzi, swing set, sliding board, barbeque area, and sundeck. Landscaped trees and greenery surround the space and I can visualize many family gatherings here. As we settle into thick plumpy lawn furniture, he places his cell on the hi-tech stone fireplace in front of us and adds, “But they’ll be able to go to the park everyday….” Mr. B., whose favorite TV sitcom is I Love Lucy (“Well…my favorite after How I Met Your Mother, that is,” he grins, shooting no one in particular a side glance) and favorite film is West Side Story, relishes the move and is looking forward to the four seasons. Raised in Michigan and later residing in New York in the late nineties, he quips with urgency, “I’m a New Yorker, man.” In 2004, he and Neil met on the streets of Manhattan, by coincidence, through a mutual friend—“On 44th and 8th,” he gleefully remembers. Both were performing in Sam Mendes-directed musicals: David in Gypsy, playing Tulsa, and Neil in Cabaret, playing The Master of Ceremonies. David’s cutie-pie looks, slender athletic body, treble-pitch honey voice, and sparkly, engaging demeanor belie the fact that he is intelligent, hardworking, and compassionate. Before David and Neil met, David appeared in a tender gay-themed movie called 24 Nights that won several awards on the indie film festival circuit. His next gig was on the Broadway stage A&U • APRIL 2014

in Gypsy, where he sang and danced alongside Bernadette Peters. Later cast in Edward Albee’s play, The Play About the Baby (“Working with this incredible man was such an inspiration to me”), he received the 2001 Clarence Derwent Award for most promising male performer. He

racked up other stage credits and made his television debut on The West Wing, followed by appearances on Crossing Jordan and CSI:NY. After he and Neil became partners, doors may have opened slightly, but it was David’s own talent that landed him work. He made

a guest cameo in A Very Harold and Kumar 3-D Christmas, where he and Neil have a sidesplitting scene, satirizing their own relationship. He also had a reoccurring role on How I Met Your Mother, playing Scooter, Lily’s former high school boyfriend. In 2009 David took a break from A&U • APRIL 2014

acting and earned a culinary arts degree from Pasadena’s Le Cordon Bleu. He established a catering business with classmate Molly Hanisee called Gourmet M.D., which may be phased out once he moves to New York. His roster of clients has included Christina HenAPRIL 2014 • A&U

dricks, Zachary Quinto, Cat Cora, and Jesse Tyler Ferguson. David even appeared as a guest judge on Top Chef Masters. In 2012 David reentered show business, appearing in the film Annie and the Gypsy, opposite fellow AIDS advocate Cybill Shepherd [A&U, January/ February 1995]. Later this year he returns to his roots and showcases his dancing skills in Platinum the Dance Movie, playing JT, a dorky mama’s boy whose mother runs a dance competition. “Some of these rehearsals were the hardest of my life,” he notes. Don’t miss last year’s Internet episode of Funny or Die (the Web series co-founded by Will Ferrell) titled, “Gay Christian Mingle,” a riotous short spoof starring David and Cheyenne Jackson [A&U, January 2014]. David doesn’t do many interviews, but felt the need to address the increasing number of new HIV infections. “Even though AIDS is manageable, it’s still a Big Deal,” asserts David. Watson, one of their two dogs, a poodle mix, is curled up on a chair nearby. “I’m worried about the generation under me. Some think that they can just take a pill each day and all will be fine. But that’s not the case! There are different HIV strains, and the drugs can affect each individual very differently.” He shoos a fly away from his face. “Barebacking seems to be running rampant. I’ve had some friends date a couple of nineteen-year-olds and when they get ready to have sex these kids say, ‘I only bareback.’ My friend’s reply is, ‘Are...you... fucking...nuts?!’ “They never had the experiences that we lived through. I mean, is it worth it?” David is visibly agitated. “They say, ‘Oh, you can just take a pill. It’s not a big deal.’ They give up part of their life for just one night. This is not something to just be willy-nilly about. It just doesn’t make sense to me,” he remarks, shaking his head furiously back and forth. “I mention it every opportunity I get.” He takes a beat. “I’d like to make a PSA….” (Several years ago he and Neil made a PSA for the Los Angeles Gay and Lesbian Center.)

The spectre of HIV/AIDS first entered Burtka’s life while attending high school in suburban Detroit. During that time, artist Keith Haring, a role model for David, died of AIDS-related causes. It had a profound effect on him. “I grew up with AIDS,” he states matter of factly, placing one leg under the other and propping his foot up to expose black socks, spattered in bright flamingo pink. “My generation was always so scared of the epidemic, but it was the generation before us who were most impacted. Many of my friends didn’t even have sex because they were so scared of contracting HIV.” Just then, the gardeners enter through a door from the other side of the yard. Both dogs begin to bark and sprint toward them. David excuses himself and races after Watson and Fred, a terrier mix. I suddenly feel a sense of déjà vu. Wait a minute. I realize that I’m sitting where Oprah sat when he and Neil were interviewed a couple of years ago on her show, The Next Chapter. David returns to the sofa. “Where was I?” he inquires. “I was always very, very safe even though I was very promiscuous while living in New York City.” He chuckles with a hint of embarrassment. “I mean I was crazy! I was running around with everybody….But….I always wrapped it up.” Burtka was taught HIV prevention in high school. Afterwards, when he was a student at the University of Michigan (he graduated with a BFA), he took his first HIV test. “Being in musical theater also heightened my awareness to be safe,” he says about the gay-friendly environment. “I also began professional theater when I was young and was always around older gay gentlemen. I learned from them to be careful, too.” David’s personal introduction to the epidemic occurred when he and former partner Lane were living together in New York. Lane’s best friend, Michael Strummel, who co-produced the film Boy’s Don’t Cry, tested positive for HIV. “To see him in the beginning as a vibrant, awesome, amazing, upbeat person”—David pauses as his kid-in-thecandy-store green eyes moisten—“and then to see this person become a mere shell….He’d be sick, then he’d be fine, then he’d get sick again. At twenty-four, it really opened my eyes,” he blurts in a gripping pitch. “I was one of the last people to see him in the hospital. His mom had to continually wipe the sweat from his head. He was

down to eighty pounds; he was convulsing, and couldn’t breathe. She said he knew that I was there, but I don’t know if that’s true.” He clears his constricted throat. “It was really, really hard,” recalls David. “I think every twenty-four year old should witness someone like this. It certainly made me smarter to make healthy decisions.” Several years later, in 2009, another blow shrouded David in sorrow when his mother was diagnosed with leukemia and died in just twenty days. His mother had discovered a spot on her arm and thought it was sun poisoning, but the doctor ordered her to immediately start chemotherapy. David rushed to her side, having lost his beloved grandmother only months earlier. It was a challenge being back home. “I tend to be the optimist while my dad and my sister are the pessimists and the realists,” he offers. “They were not so optimistic about the outcome. I would say, ‘Let’s be positive and give her light and love to make her better.’ They were like, ‘No, it’s done’….I think it’s so important to be positive!” underscores David heartily. “Having the right mindset can overcome difficulties just with good thoughts.” David dealt with his grief by cooking for his family (“I make a mean pasta!”) and after his mother died, he spent more time in Detroit with his father. “I’m disappointed that mom never got to see her grandchildren. In fact, it was a wakeup call for Neil and me to have kids,” he points out. David stretches his legs, touching the fire pit. He crosses his arms casually. “We kept saying to mom in the hospital that we’re going to have kids and for her to get well so she can enjoy her grandkids.” David and Neil’s relationship with their kids is not traditional. “We’ve always been the kind of couple that talks to their kids like they’re adults. We never did any of the baby talk. They’re now learning to talk and I see them speaking in adult patterns,” he says. “I think we have a very European feel to raising them. We like being open and honest with them, but of course there is appropriate content and there’s inappropriate content. If they have any questions I will answer them. I want to be friends with my kids.” He mentions that a woman who works for Elton John inspired him. “She treats her kids like peers,” reports David with an easy smile. He and Neil are good friends with Elton John, his husband David Furnish, and their two sons. They wholeheartedly support The Elton John AIDS Foundation, as well as AIDS Healthcare Foundation, Broadway Cares, and Project Angel APRIL 2014 • A&U

Food. “David is a true friend and a good man. We share a love of fatherhood and philanthropy,” Elton John tells A&U. “David and Neil have been fervent supporters of the Elton John AIDS Foundation. His willingness to get his hands dirty is one of the many reasons why I love him so. When the chips are down, David can be relied on to help straight away.” David and Neil are also involved with Children International, Feeding America, Food on Foot, and Global Green. In 2011, The L.A. Gay and Lesbian Center bestowed upon them The Rand Schrader Distinguished Achievement Award for their work with the LGBT community. The couple has participated in many fundraisers. They’ve hosted a picnic for cancer, served up a hot meal at the L.A. Mission, and sang the Cole Porter duet, “You’re The Top” at a Trevor Project event. “I just like the way it makes me feel,” says David spiritedly, when asked about his philanthropy, relating that he finds it more difficult to volunteer in Los Angeles than New York. “In New York, there’s an organization called New York Cares and they publish a monthly calendar that lists things one can volunteer for. For instance, caroling for the holidays in a kid’s hospital or picking up trash in a park or going roller skating with underprivileged children or singing at retirement homes. I was really involved with that when I lived in New York and would do it about twice a month. It’s important to give back, not only for your karma but for everybody else’s too,” he insists, licking his dry lips. “Once we’re settled in New York, I want to get my children involved as well.” David’s life may appear to be like a Doris Day-Rock Hudson movie, but to be an openly gay couple in these times can be a challenge. (Occasionally, David pinches himself back to reality. “Sometimes when I’m having breakfast with Elton in his Nice [France] house, I’m going, ‘What? Where am I? This is a legend!’….It’s strange.”) Despite David’s gratitude “for an amazing life,” it’s not an easy task to sustain the role model status in the public eye. Google his name and there are photographs of him “caught” jogging shirtless, sunning himself, pumping gasoline, grocery shopping, and walking the dog. There are even Photoshopped pictures of his head attached to porn actors! “I can’t take the kids to school without the paparazzi showing up!” David frets. “I’m in sweats and a hat looking disgusting, but I slap on a smile. They even follow the nanny to the kid’s dance class!” His quizzical eyes

expand as he beams an I-can’t-believe-it glare across his face. “That makes me mad, but if you get upset and don’t keep your cool, that’s what they want.” “I feel like I’m a very insecure person, still carrying around the hurt of a sixth grader being mocked because I was different.” He ponders a moment and continues. “I’m hard on myself. I really should be nicer to myself and enjoy life more than I do.” When asked to describe himself with one word, he interestingly replies, “Dark.” This year, the Burtka-Harrises will celebrate a ten-year anniversary. When David and Neil first made a commitment to each other they both got tested together. “We don’t get tested now; there’s no need to,” he informs, adding that they have several friends living with HIV. “For some of them I think it’s a wake-up call.” He pulls his knee up, rests his foot on the sofa, and clasps his hands around it. “Once a person is diagnosed, I think it can go two ways: either give up or start taking care of yourself. Eat healthy, exercise, stop with the alcohol, and stop doing the things that got you into trouble in the first place.” He takes his hand and gingerly brushes through his high, thick, bouncy coifed-upward bangs that have a few distinguished gray streaks. “Most of my friends are doing well but when they get sick they get a little sicker. When they get the flu it’s a little harder for them to deal with,” attests David. “It’s not like it used to be… and that’s so great. For them, fortunately, they’re doing fine on the cocktails.” The sun is now setting and David has a meeting across town. In characteristic Burtka style, he sums up with a positive spin. “It’s such an amazing time to be living, especially with all the research and new medicines that are surfacing. Elton keeps us informed,” he says, relaying that Elton is a hero for him, as is Greg Louganis [A&U, February 2008]. “It’s thrilling. We’re fighting this epidemic—and beating it. We really are…beating this epidemic.” He knocks on the wood table beside him, gazes at the ripe kumquat tree behind me, then boldly casts out a hopeful declaration, “Make…smart…choices. Wrap it!” Read the full interview on-line at www.aumag.org. Makeup by Robert Constant. For more information about Annie Tritt’s photography, visit: www.annietritt.com. Dann Dulin interviewed Cheyenne Jackson for the January cover story.

Resident Good Desert AIDS Project Offers Fresh Leases On Life Text and Photos by Sean Black

udson Mark is many things, but, most of all, he’s grateful. “Moving into Vista Sunrise Apartments was the wisest choice I’ve ever made,” shares the retired interior designer and former single-engine pilot who has struggled with the touch-andgo’s of HIV/AIDS for over thirty years. Named after the historical town in New York, where he was born and spent the first half of his life, Hudson is pleased with his recent decision, after qualifying, to move into the housing complex that sits on the Desert AIDS Project (D.A.P.) campus in Palm Springs, California, with his Chihuahua, Taxi. “I can now afford dental care along with the specialized medical treatment that I need to survive,” shares the optimistic and newly relaxed resident client. “I am finally able to get back on my feet.” Legally blind from a combination of painful medical complications and a degenerative eye disease, Hudson is also relieved and appreciative of the care and services that D.A.P. offers to him and other individuals living with HIV or AIDS. D.A.P. has been helping to improve the lives of thousands of people, like Hudson, throughout Southern California since its all-volunteer beginnings in 1984. Over thirty years, the organization has grown into an impressive facility dedicated to addressing the holistic needs of its desert city’s community, which has an HIV/AIDS prevalence rate twice the national average. An excerpt from D.A.P.’s “Guiding Principles” gives an idea of the organization’s commitment to its clients as well as to sustaining its mission: “We will always listen first, and then act with openness, honesty, and integrity so that our relationships flourish. “We will provide effective, accessi- With his trusty dog Taxi always nearby, Hudson Mark is one of the many clients that ble, and responsive services, and we benefit from Desert AIDS Project’s affordable housing, Vista Sunrise Apartments.

A&U • APRIL 2014

Oasis in the desert: Desert AIDS Project offers comprehensive services in a centralized location (above); its campus includes Vista Sunrise Apartments (below), which offers eighty units of affordable housing for people living with HIV/AIDS.

APRIL 2014 â&#x20AC;˘ A&U

On February 8, the Steve Chase Humanitarian Awards gala welcomed waves of presenters, participants, and honorees. Desert AIDS Project’s signature event raised much-needed funds for its vital services.

commit to evaluating our effort so that changes can be made when it is in the best interest of those we serve. “We will set demanding targets and make tough decisions and take considered risks to achieve them, and pursue partnership to obtain resources that enable us to do so.” Providing comprehensive care, including medical treatment, case management, and social services, like food, housing and counseling, D.A.P. focuses on prevention as well by offering free and confidential HIV testing at a number of locations throughout the Coachella Valley including at Revivals, their chain of thrift and consignment stores. D.A.P. is the lead partner in a region-wide, multi-year, multi-million dollar HIV testing campaign called Get Tested Coachella Valley that has already attracted participation by fifty-plus partners, including all three local hospitals. Desert Regional Medical Center, and its parent Tenet Corporation, stepped up in a big way with a gift of $1.5 million, attracting the approval of former President Bill Clinton, who visited D.A.P. in January as a part of the Clinton Health Matters Initiative’s considerable local efforts. In an earlier press release, David Brinkman, CEO of Desert AIDS Project stated: “In 2013, almost eighty-nine percent of our clients were living at or below

200 percent of the Federal Poverty Level, which is just under $23,000 for one person.” He continued, “With HIV medications averaging $25,000 or more annually, its easy to see why many of D.A.P.’s clients need assistance with housing and so many other aspects of daily living that you or I might take for granted.” To address this critical dilemma, which Marketing & Communications Director Barry Dayton admits, “sometimes exceeds capacity,” D.A.P. provides housing services and supplemental assistance to more than 450 individuals living with HIV/AIDS each year, including complete housing at its eighty-unit Vista Sunrise Apartments, where Hudson and Taxi live. D.A.P. has diversified its revenue streams to include grants and contracts from public and private funders; fee-forservice from private insurance, Medicare, and other sources; and its Revivals stores. However, support from individual donors through its Partners for Life, 100 Women annual giving programs, and the community’s support of major events such as Dining Out for Life, Desert AIDS Walk, Dinner at My Place, Dancing with the Desert Stars, and Mid-Summer Dance Party, also provide crucial funding. D.A.P.’s signature benefit, the Steve Chase Humanitarian Awards gala, was named in memoriam of acclaimed interior designer Steve Chase who

was an active D.A.P. donor/volunteer/ board member for many years until he succumbed to AIDS-related complications in 1994. The 2013 gala raised more than $1.4 million for client services, thanks in no small part to the support of generous sponsors including Integrated Wealth Management, Wells Fargo, Eisenhower Medical Center, Walgreens, Desert Regional Medical Center, Harold Matzner, Annette Bloch, Helene Galen, Auen Foundation, Elgart Aster and Paul Swerdlove, Donna MacMillan, Hard Rock Hotel, and Reaction Marketing, along with many others. “For twenty years, the Steve Chase Humanitarian Awards gala has entertained Desert AIDS Project supporters and crystallized the organization’s mission,” said Barbara Keller, D.A.P. board chair and gala co-chair since 2009. During this year’s gala she announced, “Tonight, I promise you’ll understand, like never before, the reasons D.A.P. is so vital to our desert community. You’ll understand where we’ve been and know how far we’ve come.” In addition to Keller, the gala was cochaired by Jim Casey of Integrated Wealth Management, a presenting sponsor for the last six years. The entertainment line-up included LaTonya Holmes, Jane Krakowski, Tomasina Abate, Eden Espinosa, Nita Whitaker LaFontaine, Eric Martsolf, choreA&U • APRIL 2014

Clockwise from top left: As a performer, Jane Krakowski (30 Rock) headlined the Steve Chase Humanitarian Awards gala. Other attendees included: Senator Barbara Boxer and husband, Stewart Boxer; actress and singer LaTonya Holmes, who also performed, and date, Aaron Lewis; D.A.P. board chairperson and gala co-chair Barbara Keller and 2014 100 Women honoree Terri Ketover; and Front Seat Chronicles’ Gilles Duarte and Josh Feinman.

ographer Ray Leeper from the hit TV show So You Think You Can Dance along with ten of his best dancers and the singers of Live It Up Productions under the creative direction of Trini Garza and his co-creative director Brandon Alameda. Presenters included Brinkman, Keller, philanthropists and major sponsors Annette Bloch and Harold Matzner, actress Donna Mills, journalist Steve Bolerjack and AIDS and gay rights activist Peter Staley. Local honorees included Curt Ringness, Terri Ketover, and David Kaplan and Glenn Ostergaard for their outstanding service, leadership and community contributions. Added to this year’s gala event was “AIDS in Cinema” a special 2014 Arts APRIL 2014 • A&U

and Activism Award given to creative advocates for their contributions in the fight against HIV/AIDS through film. Winners included Don Roos, writer of Boys on the Side, a feature film that included an HIV-positive character; David France and Joy Tomchin for How to Survive a Plague, the Oscar-nominated documentary about activism during the first decade of the AIDS crisis; Ron Nyswaner and Ed Saxon for Philadelphia, the Oscar winner starring Tom Hanks; and Sarah Pillsbury and Midge Sanford for And the Band Played On, the groundbreaking HBO docudrama based on the nonfiction book by Randy Shilts. Walking the red carpet as well were producer Josh Feinman and actor Gilles Duarte, part of collaborative television project titled Front Seat Chronicles,

where storylines for episodes are contributed by “people who have never written for TV or film but are simply sharing their real-life stories,” shares Feinman. He continues, “D.A.P.’s Steve Chase event further motivated me and my creative partner Allen Sowelle to explore the types of conversations that will ease shame and shed light on the stigmas that surround the virus.” “Our episode ‘If I Tell You’ is an attempt to stir up awareness,” he adds. Duarte stars in the French version of this HIV-themed episode. “It’s a great evening of activism and entertainment with something for everyone,” said Casey. For Hudson Mark that “something” is his life and for that he’s truly thankful. For more information about Desert AIDS Project, log on to: www.desertaidsproject.org. D.A.P. facilitates ways to participate in raising funds and awareness, such as the upcoming Dining Out for Life (April 24) and Queen of the Desert: A So-Cal Lip Sync Competition (May 28). Sean Black is an Editor at Large for A&U. He interviewed and photographed Phill Wilson of the Black AIDS Institute for the February cover story.

lifeguide

Close to the Edit

a functional cure candidate modifies genes to create hiv-resistant cells

cells are separated out to be modified. CD4+ T-helper cells, much needed for immune protection, are rendered ineffective and die off as a result of HIV infection. SB-728-T infusions have shown long-term increases in CD4+ T-helper cells, which correlates with increased CD4 central memory cells and gene-modified central memory cells. What’s modified? Using Sangamo’s proprietary genome editing technology—zinc finger nuclease, or ZFN—the extracted cells’ DNA is modified to mimic those one percent of individuals who have been found to be immune (or largely resistant) to HIV because of a natural (and apparently harmless) genetic mutation: CCR5delta32. Having CCR5delta32 results in the expression of a shortened, or truncated, and non-functional CCR5 protein, whose co-receptors are needed for HIV to gain entry into cells. Individuals who have two

copies of the mutation are virtually immune, and this is one possible mechanism that has tagged some individuals as elite controllers or long-term non-progressors, meaning some are still able to be infected by HIV but also able to indefinitely control HIV with low or undetectable HIV-1 viremia without antiretrovirals. What happens after re-infusion? Billions of cells are reintroduced and go through a process of engraftment. Researchers used one cohort to study to what extent, and at what dose, this engraftment is primed by a short-term, one-time infusion of a chemotherapeutic agent known as Cyclophosphamide, or Cytoxan (CTX). Another cohort showed that CD4 cells can be significantly increased, viral load decreased as much as ninety-nine percent, and the ZFN-modified CD4-cell count can be increased with increasing doses of CTX therapy. Two of A&U • APRIL 2014

photo by Thomas Evans

ary Blick, MD, AAHIVS, Medical & Research Director of CIRCLE CARE Center and Chief Medical Officer of World Health Clinicians, doesn’t throw the word “cure” around lightly. As an HIV physician for over thirty years, he remembers when researchers were buzzing about a possible HIV vaccine in 1984 (“give it ten years”) and how the horizon of expectations kept being shifted forward (“give it ten more years”) as predicted deadlines would pass without any good news (“we’re not sure when or if”). Now, building on years of research and the momentum created by the bone-marrow stem-cell transplant that cured the Berlin Patient (Timothy Ray Brown), attention has increasingly focused on the possibility of a functional cure, the ongoing and sustained control of viral load without antiretrovirals. A functional cure would mean that antiretrovirals, which bring with them lifelong benefits as well as lifelong challenges, such as major expenditures (the U.S. government spent $27.7 billion in research, services, and treatment of HIV in 2012 alone), kidney and bone marrow toxicities and other side effects, would no longer be needed long-term. With early but significant successes, a gene-therapy product, pioneered by Sangamo Biosciences called SB-728-T, has found its footing among the nascent field of functional-cure candidates. Dr. Blick is excited about the results from initial clinical research on SB-728-T, but his excitement is tempered with waitand-see realism. Sharing the latest news about this new therapy, he had a busy time as a presenter at this year’s Conference on Retroviruses and Opportunistic Infections (CROI 2014). Data from a raft of SB-728-T clinical trials led by Sangamo BioSciences, and in which Dr. Blick is an investigator, shows significant viral load reduction through an intravenous infusion of billions of a patient’s own CD4+ T-helper cells, ones that have been extracted, genetically modified, and re-infused into the body. What’s extracted? First blood is extracted and then the individual’s own CD4+ T-helper

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three subjects treated with the highest dose of CTX remain on treatment interruption for eleven and twelve weeks with stable or lowered levels of viral load. Overall, the study showed that an individual’s T cells can be safely engineered via ZFN-based genome editing to make them HIV-resistant and safely infused, resulting in decreases in HIV viral load off antiretroviral therapy. In another cohort discussed at CROI, one patient has shown ongoing control of viral load with nearly undetectable levels of HIV for thirty-one weeks (now thirty-five weeks as we went to press) without antiretrovirals. This patient, who looks to be on his way to a functional cure, was discovered to have one copy of the CCR5delta32 mutation and has been enrolled in a Phase II trial focused on other individuals without identical pairs of genes for the same trait (heterozygous). “We figured it would be a whole lot easier to do the gene modification if you only have one of two alleles that we needed to modify,” notes Dr. Blick. In other words, this process mimics homozygous individuals, who have two copies of the CCR5delta32 mutation. This patient at baseline had a greater percentage of T cells where both alleles were modified and fully resistant to HIV. Levels of circulating cells with biallelic modification of CCR5 may correlate with control of viral load, according to early analysis. The information will add to the bank of knowledge of how to best use this gene-modified therapy with individuals who do not carry any mutation. Dr. Blick reports that this individual’s gene-modified T cells are also being analyzed to see if they may be hiding HIV DNA within them. Currently the gene-modified therapy uses an adenovirus vector as a delivery system. The limitation of the adenovirus vector is that it may cause the body to produce antibodies, which ultimately can interfere with the engraftment of the associated gene-modified cells. Thus, Sangamo is looking at other delivery systems, namely, mRNA (messenger-RNA). As RNA is a natural part of our bodies, unlike the adenovirus, explains Dr. Blick, the body will not produce any antibodies to run interference against the engraftment of the gene-modified cells and strengthen the possibility of an efficacious functional cure, as well as allow for repeated infusions, if found necessary. The gene-modified, CCR5-disrupted cells function to not only resist infection by the most common strain of HIV but prevent its persistence. Significantly, the modified cells have

been to shown to have a longer life than the unmodified cells when exposed to HIV during a planned interruption of antiretrovirals, and, importantly, have been found to circulate where latent HIV hides out, such as gut-associated lymphoid tissue. “Lymphocytes have a normal lifespan. And T cells are lymphocytes,” reminds Dr. Blick. “So you know they’re going to have a normal lifespan, typically no greater than 120 days. If infected with HIV and not immune they’re going to die earlier than 120 days. The lifespan of the gene-modified cells—the half-life of gene-modified cells [was shown to be] something like forty-eight weeks, almost one year. We’re actually learning now that it’s going to be quite a bit longer. These gene-modified cells, for some reason, last significantly longer than if they weren’t genetically modified.” This discovery of preferential survival has been enlightening in terms of measuring the reach of gene-modified cells. “As we’re giving 10 to 40 billion T cells, you expect to see a big bump up in the person’s CD4 cell count and then come down gradually, during treatment interruption, toward the end of treatment interruption, or if they stay on treatment interruption. But they always stayed somewhere around two to three times higher than the individual’s baseline. So, when the cells come down, where are they going? “We know these T cells are trafficking into lymphoid tissue. These T cells are going into those reservoirs, just like the old T cells did with virus in them.” The difference here is important as antiretroviral drugs have not been shown to follow these infected cells into the reservoirs. “These gene-modified cells will not have virus in them because they’re immune and will fill up these reservoirs. We’ve demonstrated that already.” Asked if this type of gene-modify therapy might work best in virally suppressed treatment-experienced patients, Dr. Blick responds: “At the very beginning when we started this clinical trial, about a year and a half ago, we thought a T-cell ratio, the CD4/CD8 ratio over 1 would be the parameter that would predict the best responses. We thought that an individual who was HIV-positive for less than ten years would give the best responses. We learned through the clinical trial that was not so. So now we’re treating anybody, no matter what their duration of HIV is or what their CD4/CD8 ratio is. “But there are some exclusion criteria for these first group of patients. To get into these studies, you have to have

500 or more T cells, and you’ve got to be undetectable, because we don’t want virus replicating at the time you’re giving the gene therapy. In fact, when we give the gene therapy, we wait an additional six weeks for older T cells to die off so that the engraftment of the gene-modified T cells can take hold. And six weeks after we do the gene therapy is when they come off their medication.” As the trials are using a chemotherapeutic agent, the FDA requires other criteria to be met, as well, such as platelet counts of 200,000 and neutrophil counts of 2,500 or greater. “We’ve been learning as we go along but so far we’ve had nothing negative to say about [the therapy],” notes Dr. Blick. Mild nausea seems to be the most severe occurrence. Next steps in this research include the addition of a study arm to continue studying CTX dosing to achieve the best engraftment of cells (results presented were based on 1 gram/meter2; the new arm will look at 1.5); finalizing the technology for an mRNA-vector gene modification; and, once all the data from this Phase I/II study is collected about cell infusion and CTX dosing and checks out completely for safety, moving onto a Phase IIa study. “This is really, really early data at this point,” Dr. Blick reiterates. “So, as long as everything keeps going well with this clinical trial, we have that first sign of a prolonged functional cure [in a person] now at thirty-five weeks; and now we have a second person who dropped about ninety-nine percent of his viral load, 1.9 logs. He’s still doing well. Early numbers, very few people in these Phase I clinical trials—so it’s best to say we’re cautiously optimistic. “For me, as I’ve been doing research since 1990, understanding and uncovering all of these key findings as we go on is one of the most exciting things about doing this. We always have to give the credit to the patients for even getting involved with us and helping further the whole science of this, but just to watch this process step by step by step and learning how these things work and potentially coming up with the first functional cure for HIV is such an exciting field to be in, and such an exciting time right now.” For more information about World Health Clinicians, log on to: www.worldhealthclinicians. org. For more information about Sangamo BioSciences, Inc., visit: www.sangamo.com. Chael Needle wrote about a humanized BLT mouse model used in AIDS research for the March issue. A&U • APRIL 2014

FEBRUARY 2014 • A&U

lifeguide

Questions to Answer the word from croi 2014 maps out research knowledge gaps

Sustained Remission So where are we in the pursuit of the sustained remission of HIV? John Mellors from the University of Pittsburgh, a prominent HIV physician and researcher, provided CROI 2014 attendees with a look at the current state of HIV “cure” research. He began by stating, “The bar to HIV infection is very high.” Especially for an eradication cure and one that works for everyone. Dr. Mellors believes more remissions are on the horizon in specific populations like those described above. However, research still has many fundamental knowledge gaps, the answers to which are likely necessary to achieve the sustained remission of HIV for the majority of HIV-positive individuals. Some of the most pertinent knowledge gaps, according to Dr. Mellors, are that we don’t understand the origin of persistent virus, viral rebound and reservoirs and he asks the important questions: What is persistent virus? Is it provirus that was latent and is now activated? Is it long-lived productively-infected cells? Is there ongoing replication occurring, possibly in sanctuary regions? What types of cells are involved and what are their anatomic locations?

What is the origin of rebound virus? Is it single cell or multiple cells? Is it one tissue or multiple tissues? Another key barrier is latency, about which there are many unanswered questions, such as: What is the role of latent provirus in viral rebound? What are the mechanisms of latency in vivo? How can latency be reversed in vivo? Are there latent proviruses in tissues and how do we measure them? Are some intact proviruses permanently latent? Could we induce permanent latency as opposed to waking up latent virus to activate and eliminate it? Dr. Mellors also states the need for a biomarker that predicts time to rebound the way we have viral load assays to measure success or failure for ARVs. These are the fundamental basic science questions that researchers will be attempting to answer as they move forward towards sustained remission. Early ARV initiation in HIV-Infected Infants Further reports of success with very early antiretroviral treatment in infants born with HIV were reported at CROI 2014. Dr. Deborah Persaud from Johns Hopkins School of Medicine provided an update on the child known as the “Mississippi Baby” and also announced the existence of a second child who has reportedly tested positive for HIV at birth and has seroconverted with the initiation of ARVs shortly after birth. The second child remains on antiretroviral therapy and until therapy has been discontinued, these results should be viewed with optimistic caution. The Mississippi baby, now forty-three months old, has been off antiretroviral therapy for twenty-three months and remains undetectable for HIV. Dr. Persaud states that very low levels of HIV DNA have been found in peripheral blood mononuclear cells (PMBC’s) but believes these traces are likely not relevant and are not capable

of replication. No HIV-specific immune responses have been found in the child. The second baby is a baby girl born in Long Beach, California, to a mother with untreated HIV and a viral load of over 138,000. The HIV status of the Long Beach baby was confirmed through blood and cerebrospinal fluid at four hours-old and she was given a combination of zidovudine, lamivudine, and nevirapine, which was switched at two weeks for lopinavir/ritonavir, zidovudine and lamivudine. The child’s viral load dropped to undetectable levels utilizing standard assays at six days post-treatment. At 2.2 months of age the baby tested negative with an HIV DNA test and negative with a Western Blot test at nine months. Unlike the Mississippi Baby, the Long Beach child remains on treatment. Low levels of HIV provirus have also been detected in this child. Clinical trials of early initiation of antiretroviral therapy in infants born with HIV are said to be beginning shortly. If results of these trials echo the outcomes thus far seen in these two children, updated guidelines will likely be developed for babies born to HIV-positive mothers not on treatment. Jeannie Wraight is the editor-in-chief and co-founder of HIV and HCV Haven (www.hivhaven.com) and a blogger and writer for TheBody. com. She is a member of the Board of Directors of Health People, a community-based organization in the South Bronx and an advisor to TRW (Teach me to Read and Write), a community-based organization in Kampala, Uganda. She lives with her husband in the Bronx, New York. A&U • APRIL 2014

illustration by Timothy J. Haines

f there is a single message that came from this year’s Conference on Retroviruses and Opportunistic Infections (CROI 2014) in regards to curing HIV or achieving sustained remission, it would have to be patience and persistence. Despite the advances over the past several years in particular groups of people, the overall path to a widespread cure or remission of HIV is going to be a long, slow and arduous journey, ripe with small victories and disappointments; a step-by-step process of discovery. It is apparent that advances and successes will likely come in specific populations such as we are beginning to see in newborns, cancer/HIV patients needing stem-cell transplants, and people who initiate therapy very soon after seroconversion.

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Pharma C

specialty pharmacies expand to improve hcv drug adherence

Specialty pharmacy services have been used for years in the treatment of chronic conditions and in complex treatment regimens for cancer, rheumatoid arthritis, MS, hepatitis and other diseases that require a complex set of medication and ongoing management of side effects, dosage changes, refills and adherence. What’s new for HCV is the explosion of new antiretroviral oral treatments available and coming onto the market and a new influx of patients who didn’t have insurance and may be unfamiliar with the labyrinthine (and quickly changing) med-

ical-pharmacy-insurance system. Retail giants with pharmacies have taken notice of these changes. Walgreens is the latest, but not the only, large retailer to expand its hepatitis C-specialty pharmacies. In February, the Deerfield, Illinois-based giant expanded access to its 100 hepatitis C-specialized pharmacies with pharmacists who specialize in new oral therapies. Walgreens’ Connected Care hepatitis C program is an education and support plan designed to help patients “achieve a sustained virologic response (SVR) and an improved quality of life through medication adherence,” according to Glen Pietrandoni, Walgreens Senior Manager, Virology, Pharmacy Services. Pietradoni tells A&U that the expansion comes at a critical time when a once potentially deadly condition is now increasingly curable and a growing number of Americans with hepatitis C have access to health insurance. “Walgreen’s has been offering specialty services for HCV since 2000, but now, with the advances in therapies available, and the complexity of their interactions, these specialty services are needed now more than ever,” Pietradoni says. He adds that the growing number of people who have access to healthcare through the state exchanges and Medicaid expansion as part of the Affordable Care Act (Obamacare) has introduced more patients who need help navigating the insurance system and understanding how their meds work. “Very often patients with hepatitis must deal with co-morbidities such as HIV co-infection or diabetes or high blood pressure, which can make managed care and the interaction between medications even more complex to manage.” Programs like Walgreens Connected Care and other specialty pharmacies take a holistic approach to managing health outcomes. Often patients work with specially trained pharmacists to determine the best method of delivery and they can pick up HCV medications at a specialized pharmacy or a designated local retail pharmacy. In addition to access expertise and clinical support, many specialty pharmacies offer

services that include: • full support of prior authorizations • coordination of financial assistance including co-payment assistance for eligible prescriptions • patient care advocates • routine communication and updates with doctors’ offices. • drug administration counseling including injection training when patients begin therapy • regular refill reminder calls • 24 hour a day access to pharmacists who can counsel on medication management and services Walgreens isn’t the only large retailer jumping into HCV care. Late last year Giant Eagle acquired Rx21 Specialty Pharmacy to provide enhanced services to hepatitis C and organ transplant patients and providers. “Giant Eagle’s commitment to delivering specialty medications with value added services such as patient education, financial counseling and prior authorization assistance for the doctors makes for a perfect partnership with Rx21,” said Rx21 Owner David Hollis in a prepared statement. If more studies come out showing the effectiveness of specialized pharmacies and a greater need for patients with HCV who need “hand-holding,” expect even more large retailers to jump in and introduce or expand HCV-centric pharmacy services. Larry Buhl is a radio news reporter, screenwriter, and novelist living in Los Angeles. His young adult novel, The Genius of Little Things, debuted last year. A&U • APRIL 2014

illustration by Timothy J. Haines

edical practitioners know there are many barriers to adherence for patients with the hepatitis C virus (HCV), ranging from co-morbidities like HIV and diabetes to managing interactions of multiple medications, to figuring out how to pay. Specialty pharmacies that cater to HCV patients are helping to reduce these obstacles, through the use of real-time data to identify adherence problems and clinical consultations with HCV specialist pharmacists to teach patients how to use the drugs and how to deal with side effects. Recently some big retailers have stepped up to offer and expand specialty services for HCV patients. There’s evidence to show specialty pharmacies can bring better outcomes. A study released last year by the American Journal of Pharmacy Benefits showed that specialty pharmacies that cater to patients with HCV and other chronic diseases can improve adherence to drug regimens and avoid complications over traditional retail pharmacies. The study, conducted by Express Scripts, tracked more than 2,200 hepatitis C patients (1,489 who used specialty pharmacy and 741 who used retail pharmacy) for up to fifty-two weeks after the start of treatment and found: • Patients using a specialty pharmacy had an 8.6 percent higher adherence rate than those using a retail pharmacy. • Specialty pharmacy patients had fifteen fewer therapy gap days (days without any available HCV medication). • Patients who exclusively used a specialty pharmacy had a sixty percent higher likelihood of achieving optimum adherence compared with retail pharmacy users.

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E R U T CUL S THE

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BOOKS

I Loved You More by Tom Spanbauer Hawthorne Books

Tom Spanbauer’s latest novel, I Loved You More, is about a writer, Ben Grunewald, who is left bereft and brokenhearted after a rift opens up between him and his best friend, Hank Christian. The rift is caused by Ben’s other friend, Ruth Dearden (“Fucking Ruth Dearden, man.”), with whom Ben once had “a thing.” Told mostly in flashback, the story about Hank—and Ruth—spills out of Ben in a torrent of words as if he’s opened a vein “that’s pulsing truth.” The language is impassioned, funny, and profane, while the narrative boomerangs back and forth in time. The same phrases recur throughout the novel in an insistent, almost argumentative way, the way they would during an all-night conversation. It’s as if Ben is sitting across from Hank in a burger joint telling him all about, well, all about Hank, a man whom he describes as “friend, lover, hero.” Not only does Ben have a point to prove, to wit that he loved Hank more, but now he has nothing but words with which to bridge an unbridgeable chasm. When Ben Grunewald tests positive for HIV, the doctor tells him he is going to get sick and die. It is 1988. He is living in New York City and knows a handful of men who have died of AIDS but realizes there are more “in a city of thousands and thousands of men sick and half-dead…full of fear and dread and alone with their fear.” He describes walking down a hallway in St. Vincent’s Hospital, “room after room after room, young men who look like old men with oxygen masks and IVs, tubes coming out of every orifice.” Twenty-two years later, Ben returns to Manhattan on a pilgrimage. He’s sixty-years-old, wearing baggy Bermuda shorts, white socks, and black tennis shoes. He has his reading glasses, a pocketful of anti-anxiety pills, and a wad of toilet paper (just in case). Since Ben’s still standing after twenty years, albeit with the help of a knee brace and foam rubber sole supports, he knows it is incumbent upon him to tell the story. Not only the story about the “epidemic of fear, the purple

sores, the wasting, the dementia,” but the story about Hank Christian and the “love affair” that spanned more than two decades. Known for his Dangerous Writing workshops in Portland, Oregon, Tom Spanbauer encourages writers to probe the “sore spot.” In I Loved You More, he makes it clear that while you’re gingerly exploring your “sore spot,” there’s someone in your life—someone who loves you—who already knows where your “sore spot” is and is capable of using a few well-chosen words like a bolt gun to bring you crashing to your knees. The characters in I Loved You More prove themselves to be more than proficient in using words to cut each other to the quick. “I can hurt you, and because I know I can, I will.” Not surprisingly, wordsmith Ben Grunewald is a heavyweight who knows how to deliver a knockout punch, and the novel starts with the very words he uses in a letter to Hank to deliver the killing blow to their friendship. I Loved You More is about the power of words. There are many passages in the novel that achieve dizzying heights of unabashed beauty and lyricism—passages describing Beethoven’s Fifth groaning on a turntable during an electrical storm and snow drifting across a room with a wrought-iron wedding-ring bed—but sadly, for Ben Grunewald, words can comprise a requiem for a lost friendship, but they cannot resurrect one. —Sally Hessney

FILM

God Loves Uganda

Directed by Roger Ross Williams Full Credit Productions/Motto Pictures

It’s been a rough couple of years for anti-gay forces in the U.S. and the western world. But anti-gay western Christian evangelicals have found fertile ground—they admit it freely—to spread their “Jesus hates homosexuality”

message in Uganda, the buckle on the African Bible belt. Roger Ross Williams’ documentary God Loves Uganda is a compelling glimpse into American evangelical “armies”—their term— that claim to spread the Gospel, but have also sparked an LGBT pogrom. Williams has unprecedented access to a group of wide-eyed, perpetually upbeat young white missionaries who aim to convert Ugandans. These sweetly naïve twenty-somethings—a cheerful married couple fails to make the connection between their outreach and anti-LGBT violence— seem harmless enough. Some scenes are borderline amusing: missionaries parroting scripture to villagers who either don’t understand or care what they’re saying, and Ugandan preachers, trained in America by U.S. evangelicals, preoccupied by “eating poo-poo,” a practice supposedly part of The Homosexual Agenda. Less amusing is the fact that Uganda’s “Kill the Gays” bill was a direct result of influence by U.S. ex-gay leader and gay hater Scott Lively and Lou Engle, leader of the Kansas City-based International House of Prayer (yes, IHOP). Then there’s abstinence-only, one of the policy strings President Bush put on HIV/AIDS funding in Africa that has now become a de-facto public policy in Uganda. With western churches reversing the pro-condom messages there, it’s no surprise that the HIV rate has begun to rise. There are glimmers of hope in God Loves Uganda, but those who value tolerance and justice may come away from the film with unease about America’s biggest export to this nation. —Larry Buhl Sally Hessney is a program assistant at a nonprofit organization, where one of the educational missions is to educate teenagers about the dangers of binge drinking, prescription drug abuse, distracted driving, STDs, and other consequential issues. Larry Buhl interviewed Dudley Saunders for this month’s Gallery. A&U • APRIL 2014

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A Calendar of Events

IDS 2014, the XXth International AIDS Conference, will be setting up shop in Melbourne, Australia, from July 20–25. Scientists, healthcare workers, activists, policymakers, people living with HIV/AIDS and other participants will be “Stepping Up the Pace,” the theme of this edition of the biannual conference. Organized by the International AIDS Society (IAS) and various partners, the conference will be chaired by researchers Françoise Barré-Sinou, PhD, 2008 Nobel Prize winner in Medicine for co-discovering HIV and IAS president, and Sharon Lewin, FRACP PhD, whose recent work has focused on activating latent HIV. The conference seeks to reinforce the message that it is an opportune time to re-dedicate ourselves to working toward the end of AIDS and enlist others to walk beside us. Organizers wish to build on—rather than lose—the momentum that has been energized by recent advances in research and newly empowered individuals and communities. Along with a focus on the Asia Pacific region, the conference will cover key topics such as post-Millennium Development Goals, investing now to secure a better future, underserved populations, stigma and discrimination, vaccine and cure research, universal access to treatment and care, among others. Some of the nineteen plenary speakers are Mark Dybul, the Global Fund to Fight AIDS, Tuberculosis and Malaria; Olive Shishana, South Africa; Khuat T.H. Oanh, Vietnam; Susan Kasedde, UNICEF; and Shaffiq Essajee, United States. Consider becoming a delegate or keep track of AIDS 2014’s reports if you cannot attend by visiting: www.aids2014.org.

TED ALLEN continued from page 35

ing the Affordable Care Act. When you are young, you think that nothing bad will ever happen to you. But you need to be prepared, in case you do get infected, in case, you know, you do get, God forbid, hit by a bus. It’s [all] part of being a responsible part of the society—to protect yourself, to have insurance, and try to be safe. I’m an old man now, so I’m going to talk like that, [he laughs], and I do have insurance. But it’s hard to get to somebody who’s eighteen or twenty or twenty-two, [because] when you are eighteen or twenty or twenty-two, you don’t think about things like that. I noticed that one can register as a Dining Out for Life Ambassador on the fundraiser’s Web site. What exactly is a Dining Out For Life Ambassador? [Part of the ambassadors’ role is to] recruit new restaurants for the cause. On the evening before the event, they go to all the [participating] restaurants, and distribute literature, encourage

diners to know about the [participating] charities, [and] encourage people to get tested for HIV. Generally, spread information about the disease, and about the cause. Where will you be celebrating Dining Out for Life day this year? In the past I’ve gone down to Philadelphia, which is the city where this organization is headquarted, and where it started. This year, unfortunately, I’ll be in a studio shooting Chopped. So, I won’t get to go out to dinner, and party. I would probably be eating catered TV lunch, and by the time it’s dinnertime, I’d be at home, rocking back and forth, rubbing my feet. [He laughs.] If it were up to me, I would go to Philadelphia, to one of Jose Garces’s restaurants. Jose is one of our Iron Chefs and he’s a past spokesperson for Dining Out for Life. Great guy! He’s got several restaurants in Philadelphia that are great. Probably I’d go for drinks and appetizers in one restaurant, and entrée and dessert in another one. With so much on your plate, you still dedicate your time to charities across the country. Why

did you decide to become a spokesperson for Dining Out for Life? I’m just trying to get the word out. To me, Dining Out for Life is such a win, win, win, such an appealing fundraiser. It helps restaurants. It helps create jobs, support local businesses, chefs, and people who are creating with food. Obviously, it helps people with HIV, and the organizations that help them. And it encourages friends to get together with friends, and celebrate over a meal. All of these things are incredible. Visit www.diningoutforlife.com and www.tedallen.net for more information. Alina Oswald is a writer, photographer, and the author of Journeys Through Darkness: A Biography of AIDS. Contact her at www.alinaoswald.com. A&U • APRIL 2014

TRACI DINWIDDIE continued from page 37

Congratulations. What was your drug of choice? If only I had a drug of choice! Of course, I had preferences, but not much of a choice. I juggled a lot of drugs in my desperation to feel different. Any advice you could offer others who are currently using? I don’t have advice, but I can say that my life is so much better being a clean and sober woman in the world. My feelings are treasured now. There was a time when I didn’t want to feel anything. Today, I’m able to sit with discomfort and ask for help when I need it. What a relief! What a monumental accomplishment. Tell me about the AIDS/LifeCycle journey. To prepare for a 545-mile bicycle ride from San Francisco to Los Angeles over seven days, it was nothing like I’ve ever experienced before. My winter and spring leading up to the event were filled with training rides, friend making, and fundraising. A whole new community of loving people brightened my world. I felt

TIM CUMMINGS continued from page 39

to play now? When I was young, I wanted to be Treat Williams as George Berger in the movie version of Hair. I just love that film and him in that role. When he does “I Got Life” on that dining room table, with Twyla Tharp’s choreography, it’s so sexy. I just got an awesome record player for Christmas, so I broke out my old vinyl collection from childhood, and I still had the original Hair soundtrack. I’ve been listening to it like mad. What a breakthrough musical that was! The first Broadway show you ever saw was…? Phantom of the Opera. I loved it because when I was in my teen years I was really goth. The first play I saw was Lost In Yonkers with Kevin Spacey, Mercedes Ruehl, and Irene Worth—such really inspiring performances. I also saw my first Pina Bausch [a modern dance performer, choreographer, teacher, and ballet director] show around that time and have been hooked ever since.

a joyous rush from gathering my “troops” in support of this cause. I grew as I learned how to ask for donations in an unapologetic manner and to ask beyond my comfort zone. The actual training allowed me to see gorgeous, sometimes hidden, parts of California that one could only see and appreciate from a bicycle. I’d be remiss if I didn’t mention the new strength I found in my thighs! I’ll bet at times they were throbbing! [Cracking an achy smile as her gleaming green eyes squint, Traci nods in complete agreement.] What was your training regimen like? I trained from October to June and took longer rides every weekend, with a shorter mid-week ride.

Of course, I made it through, however, I learned to always carry my inhaler with me and to invest in proper gear. All of this prepared me for the actual ride. I stayed dry, warm, and healthy. My body was strong and took to the journey with gusto. What makes you care about all of this? I watched one of my very best friends attempt to rebuild his life after losing his partner to AIDS nearly twenty years ago. It was heartbreaking. So much has changed now. People with HIV/AIDS can still live productive, happy, and healthy lives with all of the new medications available. This hope for new possibilities motivates me. Lives can be turned around for the better by simply giving to AIDS/LifeCycle.

And how rough did it get out there? Well…I learned how to “clip out” [detaching the shoes from the bike pedal] for the first time in November, so, yes, it was a challenge. Had a few little spills on my bike early in my training. On my second time up Latigo Canyon, I didn’t have the proper winter/rain gear and got soaked and nearly froze my tush off. By the time I made it to the tippy top of the nine mile climb, I began to have an asthma attack.

Any last words, Traci? I just want to encourage everyone to get tested—and talk about HIV/AIDS! The more aware we become, the less stigma it holds and thus, social healing is possible.

So where did you first hear about AIDS, Tim? When I was in fifth grade. That would have been 1984. My parents were arguing profusely about AIDS and about gay men after watching something on the news one night after dinner. My father was a big Irish firefighter, my mother a voluptuous Italian opera singer. The passion and emotion and anger you saw on-stage? You can guess where I got it.

among younger people is increasing. Comment on your work with the young people you teach at the Ojai Playwrights Conference. Man, I love my kids! They have brilliant minds, are eager, energetic, and hilarious. They came down to see The Normal Heart and we did a talkback. Some of them had never heard of HIV/AIDS and had no idea that this play was not fiction. It made them really sad. They likened it to what they had learned in school about the Holocaust. HIV/AIDS absolutely…positively must be taught in schools! What are these educational administrators thinking in not allowing this vital aspect of human culture and human experience to be a mandatory element of every student’s curriculum? It baffles me. [He then yells.] People are going to have sex. [He pauses.] With whomever they like. [He pauses again.] Usually by age fourteen.

How has the epidemic affected you? I had very personal reasons for taking on Ned and doing him the way I felt he should be done—that is to say, unreservedly. I’ve lost friends, peers, and professors to this epidemic. Do you have any other causes close to your heart? I recently completed a new play that deals with gay teenagers being bullied so badly that they commit suicide. At one point during the play, the antagonist from William Golding’s Lord of the Flies shows up. It’s terrifying. I’m rather infatuated with that book, its hard themes of civility versus savagery, and I wonder where that comes into play with the bullying of young gay boys. As you know, the rate of HIV infection

To donate, steer over to Traci’s ALC Ride Web site: www.tofighthiv.org/goto/ tracidinwiddie. To groove with Traci, log on to: www.tracidinwiddie.com. Dann Dulin is Senior Editor of A&U.

Do you wanna say anything else about the epidemic? Keep fighting. Keep helping out. Don’t be afraid to be a dick! Dann Dulin interviewed Cheyenne Jackson for the January cover story. A&U • APRIL 2014

APRIL 2014 • A&U

Survival Guide

[a portrait by sean black]

[

Quintara “Lady Queen” Lane Miami, Florida An advocate born with HIV, she gave birth to a healthy baby girl on February 19, 2014.

“I placed myself with God and put my child’s needs first. I listened to my doctors and did what I was told to do.” Sean Black is an Editor at Large of A&U.

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A&U A&U • DECEMBER 2013 • APRIL 2014

WE KNOW

HIV/AIDS MEDICATION THERAPY But we also know you prefer pedaling over pumping gas. Welcome to a pharmacy that gets to know you, not just your diagnosis. We’re not just treating HIV patients, we’re getting to know individuals. So no matter the level of support, guidance and confidentiality you prefer, we’re here for you. To learn more, visit HIV.Walgreens.com.

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